Is there a role for ibandronate in the treatment of prostate cancer patients with bony metastases?

Abstract

Purpose. Zoledronic acid is widely accepted as the treatment of choice for a number of cancers which metastasise to bone and is the only bisphosphonate licensed for the treatment of prostate cancer. However, drug related nephrotoxicity, although rare, does pose a significant complication when using zoledronic acid. Prostate cancer patients are generally older than 65 years of age and already exhibit some form of impaired renal function. Thus, for prostate cancer patients who are unable to tolerate zoledronic acid there is a need for an alternative bisphosphonate. One possibility could be ibandronate which is also a potent third generation, nitrogen-containing bisphosphonate and is an attractive choice for some patients due to the fact it is available in both intravenous and oral preparations. Methods. This article reviews the current published literature regarding the use of ibandronate in the treatment of metastatic prostate cancer. Results. Preliminary data emerging from small Phase II studies suggests ibandronate may provide a therapeutic alternative for the treatment of metastatic prostate cancer when zoledronic acid is deemed unsuitable. Conclusion. Further in vivo research with ibandronate in prostate cancer is urgently needed in order to elucidate whether this bisphosphonate may play a role in the treatment and palliative management of metastatic prostate cancer.