The Hospice Clinician Blog

Late-stage drug trial results from University College, London were released Sunday that indicate that Boniva (ibandronate) may work as well as radiotherapy for pain relief in patients with prostate cancer and bone metastases.

In the clinical trial, 470 patients were given either an IV infusion of Boniva or one dose of radiotherapy. Just before the trial, their pain levels were documented. They then reported their pain levels at the same time intervals: four, eight, 12, 26 and 52 weeks after treatment. Those who had not responded to the first treatment at four weeks crossed over to the alternative therapy and received their second treatment no later than week eight.

The patients’ pain levels were measured by documenting how many painkillers they needed to take and also by using two separate pain measurement methods: the WHO pain ladder and the Mercadante method (which involves analgesic use defined in morphine equivalents, where a positive difference from baseline reflects worsening pain relief).

"Although there were more patients in the ibandronate group with worse Mercadante scores at four weeks who needed re-treatment, at six and 12 months, there was no long-term difference in pain relief between the two groups," said Peter Hoskin from University College, London, who presented the data at the European Multidisciplinary Cancer Congress (EMCC).

The median survival of the four groups was 11.8 months for those on radiotherapy only, 11.4 months for those on the Roche drug only, 12.7 months for those on radiotherapy then Boniva, and 16.8 months for those on Boniva and then radiotherapy. But Hoskin said it was too early to tell what the differences meant.

"We hope to analyze these survival differences further in the hope that it can give us pointers as to how and whether we should use a combination of treatments," he said. "Currently we are unsure about the optimal timing and scheduling of treatment for these patients.

Could your hospice benefit from access to PharmDs experienced in hospice & palliative care? Outcome Resources offers 24/7 Access for your staff to ensure your patients are getting the best clinical care. Contact Us today to learn more.

"