Table 2.

Efficacy of bone-targeted agents in patients with bone metastases

Bisphosphonate	Cancer type	Patients, N	Reduction of SREs	Reduction of pain	Acute-phase reaction	Survival benefit
Clodronate [70]	Multiple myeloma	350	Yes	Yes	No	NE
Clodronate [72]	Multiple myeloma	536	Yes	Yes	No	±a
Clodronate [74]	Breast cancer	173	Yes	Yes	No	No
Clodronate [75]	Prostate cancer	819	NR	NR	No	Yes
Pamidronate [76]	Multiple myeloma	392	Yes	Yes	Yes	±b
Ibandronate [77]	Multiple myeloma	198	No	No	±	No
Zoledronic acid [78]	Multiple myeloma or breast cancer	1,648	Yes	Yes	Yes	Yes
Zoledronic acid [79]	Breast cancer	228	Yes	Yes	Yes	NE
Zoledronic acid [80]	Lung cancer and other solid tumors	773	Yes	NE	Yes	No
Zoledronic acid [81]	Hormone-refractory prostate cancer	122	Yes	Yes	Yes	NE
Denosumab [82]	Breast cancer	2,046	Yes	NE	Yes	NE

NE not evaluated, NR not reported, SREs skeletal-related events

^aIn a post hoc analysis, patients without vertebral fracture at study entry survived significantly longer on clodronate therapy (median survival was 23 months longer compared with patients receiving placebo)

^bSurvival of patients with more advanced disease was significantly increased in the pamidronate group (median survival of 21 vs. 14 months, P = .041)