Treatment of malignancy-associated hypercalcemia with 1-hydroxyethylidene diphosphonate (EHDP) or actinomycin D

Abstract

In order to evaluate the efficay of 1-hydroxyethylidene diphosphonic acid disodium (EHDP) and actinomycin D as the agents for the treatment of malignancy-associated hypercalcemia, a randomized study was carried out, in which the effects of these agents were compared with those of calcitonin (elcatonin) and mithramycin. EHDP (400 mg/day, daily) was effective in 4 of 9 cases (44%) and actinomycin D (12.5µg/kg) in 6 of 10 cases (60%), while calcitonin (80–160 units/day, daily) was effective in 6 of 12 cases (50%) and mithramycin (25µg/kg) in all of 11 cases. In effective cases, the mean decreases in corrected serum calcium levels after the treatments were 3.2±1.2 by EHDP, 3.4±1.2 by actinomycin D, 2.9±0.6 by calcitonin and 4.1±1.2 by mithramycin (mg/dl, mean±SD). Mithramycin was, therefore, most effective, but it is not commercially available in Japan, and the duration of its effect was much shorter than that of EHDP or actinomycin D. These results together with the fact that EHDP is given orally, indicate that EHDP and actinomycin D are as effective as calcitonin and that EHDP may be beneficial for the treatment of mild to moderate hypercalcemia.