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Supportive Care in Cancer
Published in: Supportive Care in Cancer 3/2024

Open Access 01-03-2024 | Denosumab | Research

Treatment of bone metastases from solid tumors with bone-modifying agents: a web survey of Italian oncologists investigating patterns of practice drug prescription and prevention of side effects

Authors: Vittorio Fusco, Massimo Di Maio, Anna Amela Valsecchi, Daniele Santini, Marcello Tucci, Ugo De Giorgi, Paolo Bossi, Toni Ibrahim, Luigi Cavanna, Gaetano Lanzetta, Maura Rossi, Giorgia Rossetti, Mario Airoldi, Alessandro Comandone, Saverio Cinieri

Published in: Supportive Care in Cancer | Issue 3/2024

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Abstract

Purpose

Optimal use of bone-modifying agents (BMAs) in patients with bone metastases from solid tumors is uncertain in some aspects: the drug choice; the planned treatment duration and long-term therapy; the prevention and management of possible side effects, including renal toxicity, hypocalcaemia, and medication-related osteonecrosis of the jaw (MRONJ).

Methods

Italian oncologists were invited to fulfil a 24-question web survey about prescription of BMAs for bone metastases of breast cancer, prostate cancer, and other solid tumors. Prevention and management of side effects were also investigated.

Results

Answers of 191 oncologists were collected. BMAs are usually prescribed at the time of diagnosis of bone metastases by 87.0% (breast cancer) and 76.1% (solid tumors except breast and prostate cancers) of oncologists; the decision is more articulated for prostate cancer (endocrine-sensitive versus castration-resistant). The creatinine level (32.3%), the availability of patient venous access (15.8%), and the type of primary neoplasm (13.6%) are the most reported factors involved in choice between bisphosphonates and denosumab. Zoledronic acid every 3 months was considered as a valid alternative to monthly administration by 94% of Italian oncologists. Oncologists reported a good confidence with measures aimed to prevent MRONJ, whereas uncertainness about prevention and management of hypocalcemia was registered.

Conclusion

Italian oncologists showed a high attitude in prescribing bisphosphonates or denosumab at the time of diagnosis of bone metastases, with a large application of preventive measures of side effects. Further studies are needed to investigate some controversial aspects, such as optimal drug treatment duration and long-term drug schedules.
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Metadata
Title
Treatment of bone metastases from solid tumors with bone-modifying agents: a web survey of Italian oncologists investigating patterns of practice drug prescription and prevention of side effects
Authors
Vittorio Fusco
Massimo Di Maio
Anna Amela Valsecchi
Daniele Santini
Marcello Tucci
Ugo De Giorgi
Paolo Bossi
Toni Ibrahim
Luigi Cavanna
Gaetano Lanzetta
Maura Rossi
Giorgia Rossetti
Mario Airoldi
Alessandro Comandone
Saverio Cinieri
Publication date
01-03-2024
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 3/2024
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-024-08392-8

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