1359 - Multi-center observational study on the diagnosis of non-small cell lung cancer bone metastasis and the efficacy and safety of bisphosphates treatme...

Date 28 September 2012
Event ESMO Congress 2012
Session Publication Only
Topics Supportive Care
Non-Small-Cell Lung Cancer, Metastatic
Presenter Yi-Long Wu
Authors Y. Wu1, Z. Li2, C. Zhou3, L. Shun4, Y. Zhang5, M. Hou6, W. Liu7, J. Wang8, G. Chen9, Y. Zhou10
  • 1Guangdong Lung Cancer Institute, Guangdong General Hospital (GGH) & Guangdong Academy of Medical Sciences, 510080 - Guangzhou/CN
  • 2Department Of Medical Oncology, Sun Yat-Sen University Cancer Center, Guangzhou/CN
  • 3Lung Cancer Institute, Shanghai Pulmonary Hospital, 200433 - Shanghai/CN
  • 4Shanghai Lung Cancer Clinical Center, Shanghai Chest Hospital, 200030 - Shanghai/CN
  • 5Oncology, Zhejiang Cancer Hospital, Hangzhou/CN
  • 6Oncology, West China Hospital, Chengdu/CN
  • 7Oncology, Xijing Hospital, Xi'an/CN
  • 8Beijing Cancer Hospital, 100036 - Beijing/CN
  • 9Oncology, Heilongjiang Cancer Hospital, Harbin/CN
  • 10Oncology, Henan Provincal Hospital, Zhengzhou/CN



To study the current status of the NSCLC bone metastasis (BM) in China, including the diagnosis, NTX parameters, and the efficacy and safety of bisphosphates (BP) treatment.


NSCLC patients with radiographic verification of BM were treated with at least one kind of BPs in this prospective observational study. NTX, SRE incidence and adverse event (AE) data were collected at baseline and every 3 months after treatment. Treatment continued at least until death. NTX levels were characterized as normal (N; <50 nmol/mmol) or elevated (E; >= 50 nmol/mmol).


By the time of this analysis, 580 patients were enrolled into this study with the median follow-up of 6.1 months. There were 566 patients with baseline NTX results. Most patients (86.7%) had BM diagnosed using of CT containing method. The E baseline NTX patients were 374 (66.6%). Patients with multiple BM (459 pts, 81.2%) had significantly higher NTX baseline level than those with single BM (108.9 vs 67.3 nmol/mmol, p = 0.0003). The OS was 23.2 months. The overall SRE was 22.2%, and the annual SRE was 3.4 times/person/year. Patients with E baseline NTX had trend of earlier onset of SRE (the median time to first SRE: 1.2 vs 1.6 months, p = 0.179) and shorter OS (20.6 vs not reached, months), especially after 15 months. The frequency of adverse events was 17.1%, study drug related AE was 7.1%, and serious AE was 2.6%. There were no significant changes in serum creatinine levels before and after bisphosphate therapy. No cases of osteonecrosis of the jaw (ONJ) were observed. Zoledronic Acid-related AE was observed in 37 cases (7.7%), and SAE was observed in 14 cases (2.9%).


NSCLC bone metastasis is a relatively common and serious clinical problem in Chinese patients, which were most frequently identified by CT. Baseline NTX level has significant negative impact on SRE. Prolonged bisphosphate therapy could help reduce SRE with acceptable safety profiles.


All authors have declared no conflicts of interest.