Bone Mark

er
Mark
Assessmen

t
Assessmen as a Guide

to
Chronic Use of Aminobisphosphonates
in
Multiple Myeloma.
N. S. Raje, N. C. Munshi, A. K. Mahindra, S. Pozzi, P. G. G. Richardson, J.
Lb
Laubach, I . M
. Gh

ob i
r l
a , R. L
. Sh
Sc l
hlossman, K
. C
. Ad
Anderson.
Masachusettes General Hosp Cancer Ctr,; DanaFarber Cancer Inst, Harvard
Medica
Medic l School, Bost
Bos on
t
, MA

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OBJECTIVES
·
To ev
e alua
v
t
alua e
t the NTX lev
le e
v ls
e mont
mon hly for
fo 6
months
in
MM
patients
off
IV
bisphosphonat
bisphosphona e
t trea
tr tmen
ea
t
tmen after
te a single
dose of zoledronic acid. drugs.
·
To det
de e
t rmine
e
whether NTX lev
le e
v ls
e can be
used as a surrogate to tailor Zoledronic
acid therap
ther y
ap

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Study Design
30 MM patients
in CR and or PR
6 m end of study
with h/o 812
with BM aspirate
months of IV
and biopsy and
bisphosphonat
bisphosphona e
t


Sk l
e etal Survey
therapy
Baseline NTX followed by monthly x 6
Serum Markers followed by monthly x 6
BM aspirate and core
Skelet
Sk
al
elet Sur

ve
v y
e
Zoledronic acid single dose

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Results
NTx ll
levels
001
07144 NTx Values
002
003
100
004
90
005
80
006
70
007
le 60
008
v
Le
50
009
x
010
40
NT
011
30
012
20
013
10
014
0
015
01
23
4
5
6
7
016
Months
017
018

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Summary and Conclusions
· NTx levels remained low in all but 1 patient who presented
with boney progression at month 3 of followup.
· None of the other 27 patients had any e/o bone progression
di
during th
e 6

th
mon
fl
fo lllowup.
· One patient developed progress myeloma by way of increased
monoclonal pro
p tein at month 4 and was taken off the study--
y
NTx levels remained normal.
· Our data suggests that NTX can potentially be used as a
surrogate to tailor amino bi

h
sp
h
osp onate therapy.
· Our data also suggests that less frequent dosing or a
trea
tr tmen
ea
t
tmen holida

y
holida ma

y
ma be

fe
f asible
e
in MM

pa
tien
pa
ts
tien with

sta

bl
b e
disease

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