Predictor of responsibility of the treatment of bone metastases MBC: Monitoring levels of osteomarkers

The treatment of the bone metastases have two aim with the same relevance’s :stabilisation of malignant disease and prevention of the skeletal related events . Bisphosphonates are useful in inhibition of the osteoclastic antineoplastic activity and the response of levels of osteomarkers during the treatment with bisphosphonates is very quickly. Aim of our study is the monitoration levels of osteomarkers and their correlation with the clinical symptom’s of the malignant disease and later theirs correlation with prediction of the treatment responses and with prognosis of the disease.

Material and methods:

Patients with the first detection of the bone dissemination of the malignant disease. Stratification: stratum A: as ymptomatic patients Stratum B: symptomatic {pain, fracture..} Osteomarkers: CTX - C telopeptid, kolagen I, marker of the bone resorbtion ICTP - MMP telopeptid, marker of the bone resorbtion P1NP- protokolagen 1 N terminal propeptid, marker of the bone modulation. The sampling of osteomarkers started before therapy, next 14 days post the first application and next post 28 days and every month during 6 months. Laboratory: standard haematology and biochemistry including calcium levels in plasma, Denzitometry before starting and next post six month. Anamnesis, clinical examination, scintigraphy ,X rays or CT scan. Therapy: Antineoplastic: tailoring with type of the malignant disease. Radiotherapy in the cases of the limited osteolytic localities. Bisphosphonates: all patients {20}

Results: First levels of osteomarkers : all three markers elevated 4pts, ICTP+P1NP only…..8 pts , ICTP only 2pts, P1NP only elevate: 4pts,normal values of all osteomarkers: 2 pts. Decrease values post therapy 3 months going : 16 patients, Increase 1 patients stable values 3 patients. Progression of disease 1 patient post 6 months correlate with elevation of P1NP (first value was normal).

Conclusion: The study is continuated, but the prevent results are favourable. Analysis our 20 patients demonstrate the positive correlation between the regression of the clinical signs of the disease and the decrease levels of the osteomarkers.