Ibandronate May Be Alternative to Radiotherapy for Metastatic Prostate Bone Pain

A single infusion of ibandronate had outcomes similar to a single dose of radiotherapy for metastatic bone pain in prostate cancer, a recent study published online ahead of print in the Journal of the National Cancer Institute has shown.¹

For the multicenter noninferiority trial, researchers enrolled 470 patients with prostate cancer and metastatic bone pain who were eligible to receive local radiotherapy. Participants were randomly assigned to receive a single 8 Gy dose of radiotherapy or a single 6 mg intravenous infusion of ibandronate.

Researchers measured patients’ pain using the Brief Pain Inventory at baseline and 4, 8, 12, 26, and 52 weeks. Patients who failed to respond to treatment at 4 weeks were able to receive retreatment with the alternative treatment.

Results showed that pain response was not statistically significant at 4 or 12 weeks; however, researchers observed a more rapid initial response with radiotherapy.

Quality of life was also similar at 4 and 12 weeks. Overall survival was similar between the 2 treatment arms but was improved among those who underwent retreatment compared with those who did not.

In regard to safety, although each treatment had different adverse events, there was no overall difference in toxicity.

The findings suggest that ibandronate could be considered for metastatic prostate bone pain when radiotherapy in unavailable.

Reference

1. Hoskin P, Sundar S, Reczko K, et al; A multicenter randomized trial of ibandronate compared with single-dose radiotherapy for localized metastatic bone pain in prostate cancer. [published online ahead of print August 25, 2015].  J Natl Cancer Inst. doi: 10.1093/jnci/djv197.