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First Published Online January 29, 2009
The Oncologist, Vol. 14, No. 2, 181-191, February 2009; doi:10.1634/theoncologist.2008-0209
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Symptom Management and Supportive Care

Bisphosphonates in Oncology: Rising Stars or Fallen Heroes

Tim Van den Wyngaerta,b, Manon T. Huizinga, Eric Fossionc, Jan B. Vermorkena

aDepartment of Medical Oncology and bDepartment of Nuclear Medicine, Antwerp University Hospital, Edegem, Belgium; cDepartment of Oral and Maxillo-Facial Surgery, ZNA Middelheim, Wilrijk, Belgium

Key Words. Bisphosphonates • Palliative care • Adjuvant drug therapy • Osteonecrosis • Jaw

Correspondence: Tim Van den Wyngaert, M.D., Department of Medical Oncology, Antwerp University Hospital, Wilrijkstraat 10, 2650 Edegem, Belgium. Telephone (mobile): 32-473-542124; Fax: 32-3-8253308; e-mail: tim.van.den.wyngaert{at}skynet.be

Received September 19, 2008; accepted for publication January 2, 2009; first published online in THE ONCOLOGIST Express on January 29, 2009.

Disclosures: Tim van den Wyngaert: Consultant/advisory role: Novartis Pharmaceuticals Corporation; Honoraria: Novartis Pharmaceuticals Corporation; Manon T. Huizing: None; Eric Fossion: Consultant/advisory role: Novartis Pharmaceuticals Corporation; Jan B. Vermorken: None

The content of this article has been reviewed by independent peer reviewers to ensure that it is balanced, objective, and free from commercial bias. No financial relationships relevant to the content of this article have been disclosed by independent peer reviewers.

The introduction of bisphosphonates in oncology has dramatically changed the management of patients with metastatic bone disease. In this manuscript, we thoroughly scrutinize the available body of clinical trials supporting the use of bisphosphonates in this setting and review new and ongoing research. Additionally, we summarize the data showing the benefits of bisphosphonate use in the prevention of treatment-induced bone loss and the intriguing emerging evidence on the antitumor potential of some of these agents when used in the adjuvant setting. Finally, we address the need for a careful consideration of potential benefits of bisphosphonate therapy and the risk for osteonecrosis of the jaw, a recently recognized late-toxicity of their use.






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