(ChemotherapyAdvisor) – Denosumab is associated with longer overall survival (OS) times than zoledronic acid (ZA) among patients with advanced lung cancer who are undergoing treatment for bone metastases, according to an analysis of data from a randomized phase 3 study published in the Journal of Thoracic Oncology.

“In this exploratory analysis, denosumab was associated with improved overall survival compared with ZA, in patients with metastatic lung cancer,” reported Giorgio Vittorio Scagliotti, MD, of University of Turino in Orbassano, Italy, and coauthors.

Median OS time was 1.5 months longer among 411 lung cancer patients receiving monthly subcutaneous denosumab (120 mg) than among 400 patients who were administered intravenous ZA (4 mg), the authors reported. Among patients with non-small cell lung cancer (NSCLC), denosumab was associated with a 2.5-month OS advantage, compared to ZA. For patients with any lung cancer, denosumab was associated with a median OS of 8.9 months, versus 7.7 months for ZA (HR 0.80; P=0.01); denosumab was also associated with superior OS among 702 patients with NSCLC (9.5 months vs 8.0 months; HR 0.78; P=0.01).

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“Further analysis of NSCLC by histological type showed a median survival of 8.6 months for denosumab versus 6.4 months for ZA in patients with squamous cell carcinoma (HR 0.68;P=0.035),” the authors reported.

The incidence of adverse events was similar between the two groups, with serious adverse events occurring in 66% of denosumab-arm patients and 72.9% of ZA-arm patients, they noted.

“Cumulative incidence of osteonecrosis of the jaw was similar between groups (0.7% denosumab versus 0.8% ZA),” the authors reported. “Hypocalcemia rates were 8.6% with denosumab and 3.8% with ZA.”  

The higher rate of hypocalcemia among denosumab-arm patients was “consistent with the more potent antiresorptive effect of denosumab,” they noted.

Subcutaneous administration is “associated with fewer acute phase reactions and does not require renal monitoring” compared to IV administration, they added.