Supportive care in oncology

Excerpt

Bisphosphonates are an important component of the multidisciplinary management of metastatic breast cancer and have made a significant contribution to improving the quality of life and functional independence of the many patients who, despite the developments in adjuvant therapy, still develop advanced disease [1]. Following some 20 years of randomised trials, we now have a range of agents available in Europe and a choice of oral and intravenous formulations. Unfortunately, very few of the studies to date have directly compared two bisphosphonates in trials with sufficient power to identify likely differences. As a result indirect comparisons of efficacy, toxicity, convenience and health economics are frequently made. However, the conclusions of such comparisons more often reflect the opinion (bias) of the author(s) than the science within the individual studies. …