1321 - Usefulness of serial measurement of serum N-telopeptides of type I collogen (NTX) in patients with lung cancer who developed bone metastasis: a pros...

Date 28 September 2012
Event ESMO Congress 2012
Session Publication Only
Topics Translational Research
Non-small-cell lung cancer
Basic Principles in the Management and Treatment (of cancer)
Presenter Motohiro Tamiya
Authors M. Tamiya1, S. Tokunaga2, H. Okada3, K. Taira3, H. Daga4, N. Morishita5, H. Suzuki5, N. Okamoto5, K. Takeda6, T. Hirashima7
  • 1Thoracic Malignancy Dept., Osaka Prefectural Medical Center for Respiratory and Allergic diseases, JP- 583-8588 - Osaka/JP
  • 2Clinical Oncology, Osaka city General Hospital, 534-0021 - Osaka/JP
  • 3Clinical Oncology, Osaka City General Hospital, 534-0021 - Osaka/JP
  • 4Department Of Clinical Oncology, Osaka City General Hospital, 534-0021 - Osaka/JP
  • 5Thoracic Malignancy, Osaka Prefectural Hospital Organization Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Habikino-City/JP
  • 6Pulmonary Medicine, Osaka City General Hospital, 534-0021 - Osaka/JP
  • 7Department Of Thoracic Malignancy, Osaka Prefectural Medical Center for Respiratory and Allergic diseases, JP- 583-8588 - Osaka/JP



The bone resorption biomarkers urinary NTx (uNTx) and serum NTx (sNTx) have been shown to aid in the diagnosis of bone metastasis in patients with lung cancer. Patients with metastatic bone disease from lung cancer (MBDLC) are often treated with zoledronic acid. Zoledronic acid reduces the levels of bone resorption biomarkers and also the risk of skeletal adverse events in patients with MBDLC. We studied the effects of treatments including zoledronic acid on levels of sNTx during disease progression.


Patients with MBDLC at the initial diagnosis were entered to this study. sNTx was measured once a month using the sNTx assay OSTEOMARKTM serum NTx (Alere Medical). MBDLC was characterized by monthly physical examination and by bone scintigraphy every 3 months for 12 months. All patients were required to provide written informed consent.


Twenty patients were enrolled between June and December 2010. The mean +/- 1 SD of the sNTx concentrations was 19.8 +/- 5.8 nM BCE/L at baseline. In the 16 patients receiving zoledronic acid, the levels of sNTx showed a significant decrease in the first month of treatment (baseline: 21.3 +/- 5.5 nM BCE/L; one month later: 13.6 +/- 2.7 nM BCE/L; p < 0.01). During follow-up period, 12 of the patients treated with zoledronic acid experienced worsening MBDLC or had died from lung cancer, and there were statistically significant differences in the levels of sNTx at baseline (19.7 +/- 4.47 nM BCE/L), at the lowest levels after the administration of zoledronic acid (11.5 +/- 2.73 nM BCE/L) and at the point of measurable disease progression or death (13.0 +/- 2.07 nM BCE/L).


Serial measurements of sNTx in patients with MBDLC treated with zoledronic acid might predict disease progression of bone metastasis. Administration of zoledronic acid significantly decreased the level of sNTx from baseline within one month and maintained the level of sNTx lower than baseline during study periods.


All authors have declared no conflicts of interest.