An audit into the use of bisphosphonates for patients with non-small cell lung cancer and bone metastases at a tertiary cancer centre
AffiliationMedical Oncology, The Christie NHS Foundation Trust, Manchester
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AbstractIntroduction: Around a third of patients with non-small cell lung cancer (NSCLC) will develop bone metastases. In these patients, bisphosphonates reduce skeletal related events. Zolendronic acid is the most effective bisphosphonate in reducing morbidity and is recommended. This retrospective audit was performed to determine the frequency of use of zolendronic acid for patients treated for NSCLC and bone metastases in a tertiary cancer centre. Methods: A search of clinical outcome forms and the electronic prescribing system identified patients with NSCLC and bone metastases at diagnosis (1/1/16 to 1/1/17) and which of those patients received zolendronic acid. All zolendronic acid prescriptions (1/1/16 to 1/1/17, all diagnosis) were studied and those with a diagnosis of NSCLC (and not included in first search) were identified. For the patients identified above we collected further data regarding diagnosis, treatment, and bisphosphonate dosing. Results: 255 patients had bone metastases at time of diagnosis. 5/255 had a prescription for zolendronic acid (2%). Between 01/01/2016 and 01/01/2017, 386 patients received zolendronic acid of which 10 had a diagnosis of NSCLC (3%). A further 4 had a single dose for hypercalcaemia and were excluded. Further data for these groups is shown in Table 1. Conclusion: The use of bisphosphonates in patients with NSCLC and bone metastases is low in this tertiary centre, with just 2% of patients with known bone metastases at diagnosis being prescribed zolendronic acid and patients with NSCLC accounting for just 3% of zolendronic acid prescriptions, a lower figure than anticipated given the frequency of bone metastases in this patient population. The majority of those receiving a bisphosphonate were symptomatic of their bone metastases. There was variability in dose scheduling and timing with regards to diagnosis and radiotherapy. This audit has highlighted the use of bisphosphonates as an area for development in this centre.
CitationBroadbent R, Lindsay C, Blackhall F. An audit into the use of bisphosphonates for patients with non-small cell lung cancer and bone metastases at a tertiary cancer centre. Lung Cancer. 2019;127:S86-S.
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