Bone Modifying Agents for Skeletal Metastases from Lung Cancer: A Network Meta-analysis

Description

In this detailed presentation, Anthony Bozzo discusses a comprehensive network meta-analysis of randomized controlled trials (RCTs) focusing on pharmacological therapies for patients with metastatic lung cancer. The aim is to determine the best treatments regarding overall survival, skeletal-related event (SRE) incidence, and pain remission. Bozzo highlights that their meta-analysis stands out as it allows comparisons across multiple treatment arms rather than just two, significantly utilizing both Western and Chinese published data.



The analysis includes data from over 132 RCTs involving more than 11,000 patients, resulting in findings that suggest denosumab is the most effective treatment for prolonging survival in metastatic lung cancer patients, offering a survival advantage of 3.7 months over zoledronic acid, which provides a 2.5-month increase. In terms of preventing SREs, zoledronic acid ranks as the preferred bisphosphonate, while denosumab was notably not evaluated for this outcome.



The analysis of pain remission outcomes, primarily sourced from Chinese studies, reveals a diverse range of effective therapies, including some not commonly offered in North America, like radioisotope treatments. Bozzo concludes by addressing the complexities and implications of the Bayesian statistical methods employed in the analysis and underscores the importance of understanding their findings and how denosumab should be recognized as superior to zoledronic acid for overall survival in patients with lung cancer.

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