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Jean-Jacques Body

Publications and source records attributed to Jean-Jacques Body.

At least 37 records · Page 2Linked to original sources
PubMed2004

Analytical and clinical validation of the 25 OH vitamin D assay for the LIAISON automated analyzer.

OBJECTIVE: Methods to assess serum 25 OH vitamin D have improved in accuracy, precision, and ease of use. We describe the analytical and clinical validation of an automated, antibody- and microparticle-based, chemiluminescent immunoassay method for the determination of 25 OH vitamin D. DESIGN AND METHODS: The LIAISON 25 OH Vitamin D assay is a rapid automated method with first results available in 40 min, and a subsequent throughput of 180 samples per hour. Assay performance characteristics of precision and recovery were determined according to the National Committee for Clinical Laboratory Standards (NCCLS) protocols. Analytical and functional sensitivity were determined according to standard protocols. Samples for method comparison studies were obtained from routine clinical samples submitted for 25 OH Vitamin D determination or from apparently healthy normal volunteers. RESULTS: The detection limit for this assay was <2.0 nmol/L across three lots of materials. Functional sensitivity (inter-assay imprecision <20%) was 17.5 nmol/L. Total imprecision (CV) was <15% at 42.5-137.5 nmol/L. Mean (SD) recovery was 101% (13%). The assay was linear on dilution. Comparison with radioimmunoassay (RIA) yielded acceptable correlation (r = 0.88) and clinical equivalence in the range from 37.5 to 150 nmol/L. CONCLUSIONS: The LIAISON 25 OH Vitamin D assay is a rapid, accurate, and precise tool for the measurement of 25 OH vitamin D.

Case-Control Studies↗
PubMed2004

Review of ibandronate in the treatment of metastatic bone disease: experience from phase III trials.

BACKGROUND: Metastatic bone disease is a serious clinical problem in patients with advanced cancer. Bisphosphonates inhibit the activity of osteoclasts and are the treatment of choice for bone metastases. OBJECTIVE: This article reviews the efficacy and safety data from Phase III trials of ibandronate in metastatic bone disease. METHODS: Phase III data (available as of June 2004) for ibandronate were reviewed. Literature searches using the MEDLINE database and abstracts from scientific meetings were used to obtain data from Phase III trials of ibandronate. RESULTS: Compared with placebo, patients with bone metastases from breast cancer receiving IV ibandronate (6 mg infused over 1-2 hours every 3-4 weeks) or oral ibandronate (50 mg/d for up to 96 weeks) had a statistically significant reduction in skeletal complications, as measured by the Skeletal Morbidity Period Rate (P = 0.004 vs placebo). Multivariate Poisson regression analysis of the data showed that the risk of a new bone event was reduced by 40% with IV ibandronate 6 mg and by 38% with oral ibandronate 50 mg, compared with placebo (P < or = 0.003). Both formulations also reduced bone pain below baseline levels over 2 years (P < or = 0.001 vs placebo). IV and oral ibandronate were well tolerated, with adverse-event profiles comparable to placebo and no significant renal toxicity. CONCLUSIONS: IV and oral ibandronate provide meaningful clinical benefits in patients with bone metastases from breast cancer. Both formulations reduce the risk of skeletal events and provide sustained relief from metastatic bone pain. With its favorable efficacy and safety profile, and the added convenience of the oral formulation, ibandronate provides improved treatment options for managing metastatic bone disease.

Administration, Oral↗
PubMed2004

Cytostatic and apoptotic effects of bisphosphonates on prostate cancer cells.

BACKGROUND: Bisphosphonates are potent inhibitors of bone resorption frequently used for breast cancer and myeloma-induced bone disease. Zoledronic acid has been recently shown to also reduce skeletal morbidity from prostate cancer. METHODS: We have investigated the biological effects of bisphosphonates on PC-3 cell survival (MTT assay and DNA content). We compared four bisphosphonates at doses ranging from 10(-6) to 10(-4) M: clodronate, pamidronate, ibandronate and zoledronic acid. We analyzed cell cycle phases and assessed apoptotic effects of bisphosphonates by three different methods. RESULTS: Clodronate exhibited only a slight inhibitory effect on cell growth. In contrast, aminobisphosphonates markedly decreased cell growth in a time- and dose-dependent manner exerting cytostatic and apoptotic effects. The largest effects were observed after six days of exposure to 10(-4) M bisphosphonates. Cytostatic effects were observed with all three aminobisphosphonates whereas apoptotic effects were especially evident after zoledronic acid incubation. CONCLUSIONS: Aminobisphosphonates, especially zoledronic acid, markedly inhibited PC-3 cancer cell growth, through a variable combination of cytostatic and apoptotic effects. This activity could potentially contribute to the beneficial effects of bisphosphonates in prostate cancer patients with bone metastases.

Antineoplastic Agents↗
PubMed2004

Oral ibandronate improves bone pain and preserves quality of life in patients with skeletal metastases due to breast cancer.

The objective of this study is to assess the effect of oral ibandronate on bone pain and quality of life in women with metastatic bone disease from breast cancer. In two double-blind, placebo-controlled studies, 564 patients were randomised to receive oral ibandronate, 50mg once daily, or placebo for up to 96 weeks. Throughout the studies, we assessed bone pain (on a 5-point scale from 0=none to 4=intolerable), analgesic use (7-point scale) and quality of life (European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-C30 [EORTC QLQ-C30], 100-point scale). Oral ibandronate significantly reduced and maintained bone-pain scores below baseline throughout the 96-week study period (at endpoint, -0.1 vs +0.2, P=0.001 vs placebo). Analgesic use increased in both groups; however, the increase was significantly less in the ibandronate group (0.60 vs 0.85, P=0.019). Although quality of life deteriorated during the study, the decrease in quality of life was significantly lower with ibandronate therapy (-8.3 vs -26.8, P=0.032). Drug-related adverse events were generally minor and as expected with oral bisphosphonates. Oral ibandronate had beneficial effects on bone pain and quality of life and was well tolerated. These results suggest that this treatment is of considerable clinical value as a co-analgesic to patients with painful bone metastases.

Administration, Oral↗
PubMed2004

Estrogen responsiveness of IBEP-2, a new human cell line derived from breast carcinoma.

IBEP-2, an established cell line recently derived from breast carcinoma, was characterized with regard to estrogen receptor (ER) expression, cell mitogenic response to estrogenic stimulation and sensitivity to antiestrogens. In addition, we examined ER modulation following binding of agonist and antagonists, and the ER-mediated induction of progesterone receptor (PgR). ER level in IBEP-2 cells, determined by enzyme-linked immunoassay (EIA), was slightly higher than that measured in MCF-7 cells (662 v.s. 595 fmol/mg protein). When tested on IBEP-2 and MCF-7, various agonists stimulated cell growth with EC50's reflecting different estrogenic potencies (E(2) approximately diethylstilbestrol > E(1) > genistein). IBEP-2 appeared slightly more sensitive than MCF-7, especially to E(2) (at least 4-fold difference between EC50 values). By contrast, IBEP-2 and MCF-7 were equally sensitive to the growth inhibitory effect of antiestrogens 4-hydroxy-tamoxifen (OH-Tam) and ICI 182,780. As revealed by immunoblotting and immunofluorescence using anti-ER alpha antibodies, ER expression in IBEP-2 cells was modulated by E(2) and estrogen antagonists like it has been shown in other ER-positive cell lines, that is, E(2) and ICI 182,780 caused ER downregulation, whereas OH-Tam induced ER accumulation. Ligand-induced downregulation of ER involved degradation in proteasomes, since it was suppressed by the proteasome inhibitor MG-132. Exposure of IBEP-2 cells to E(2) resulted in a marked (at least 25-fold) induction of PgR, documented by EIA, immunoblotting and immunofluorescence. PgR induction due to E(2) was not modified by MG-132. Interestingly, MG-132 alone produced an ER-independent increase of PgR expression. IBEP-2 might prove to be valuable to study ER-mediated induction of PgR.

Breast Neoplasms↗
PubMed2004

Ibandronate reduces skeletal morbidity in patients with breast cancer.

Three phase III studies have assessed the efficacy of intravenous (IV) and oral ibandronate over 96 weeks for metastatic bone disease in patients with breast cancer. The primary endpoint for each trial was the skeletal morbidity period rate, defined as the number of 12-week periods with new bone complications, adjusted for the time spent on study. Both IV ibandronate 6 mg every 3 to 4 weeks and oral ibandronate 50 mg once daily significantly reduced the skeletal morbidity period rate compared with placebo ( P = .004 in each case). The studies were not powered to detect statistical significance on individual components of the skeletal morbidity period rate. Nevertheless, IV ibandronate significantly reduced vertebral fractures and the need for radiotherapy, while oral ibandronate led to significantly fewer bone events needing radiotherapy or surgery than placebo. Using a multivariate Poisson regression model, the mean reduction in the relative risk of new bone events compared with placebo was 40% with IV ibandronate 6 mg ( P = .0033), and 38% with oral ibandronate 50 mg ( P <.001). The clinical equivalence of IV and oral ibandronate was confirmed by a post-hoc Anderson-Gill analysis of time to multiple skeletal events. These results show that IV and oral ibandronate effectively reduce skeletal morbidity in breast cancer patients with bone metastases.

Administration, Oral↗
PubMed2004

Ibandronate in metastatic bone pain.

Bone pain is a frequent complication of metastatic bone disease, with severe consequences for patient mobility and quality of life. Bisphosphonates can reduce bone pain and augment palliative radiotherapy, although relief is often for a relatively short period of time. Ibandronate is the first bisphosphonate to provide sustained bone pain relief over 2 years and, unlike other bisphosphonates, has shown improvements in quality of life. In phase III studies of patients with bone disease from breast cancer, intravenous ibandronate 6 mg and oral ibandronate 50 mg reduced bone pain below baseline levels within 6 weeks. Significant reductions were maintained throughout the 96-week study phase compared with placebo ( P < or =.001). Two open, nonrandomized studies examined the effect of intensive, high-dose intravenous ibandronate (4 mg on 4 consecutive days, or 6 mg on 3 consecutive days) in patients with breast cancer or other tumor types with opioid-resistant bone pain and in patients with urologic cancer. In each study, ibandronate rapidly relieved moderate-to-severe metastatic bone pain, improving quality of life and patient functioning. Both intravenous and oral ibandronate provide effective long-term relief from metastatic bone pain. This clinical benefit may reduce the burden of metastatic bone disease on health care resources by limiting the need for analgesics and radiotherapy to the bone.

Administration, Oral↗
PubMed2004

Profiling the safety and tolerability of bisphosphonates.

Because patients with metastatic bone disease suffer a significant burden from their illness and from anticancer treatments, it is therefore important to minimize the side effects of bisphosphonates. The intravenous bisphosphonates, zoledronic acid and pamidronate, have tolerability issues that include a flu-like syndrome, injection-site reactions, and occasional renal toxicity. Because of the potentially severe nature of the renal toxicity, renal monitoring is required before each dose, with drug withdrawal if the patients' renal function deteriorates. Oral clodronate often causes gastrointestinal disturbances, particularly diarrhea; compliance is often poor because of the large tablet size and multiple daily dosing. Long-term data have shown that the bisphosphonate ibandronate is well tolerated either intravenously or orally, with a renal safety profile similar to placebo and no evidence of cumulative renal damage. Studies investigating the effects of 15-minute infusions and intensive dosing indicate that intravenous ibandronate given rapidly or at high doses is also well tolerated with no renal safety concerns. Taken together, these results suggest that the favorable safety profile of ibandronate provides an important alternative to existing bisphosphonate options for metastatic bone disease. Using ibandronate could improve patient acceptability and simplify management, with reductions in the need for safety monitoring and management of adverse events.

Administration, Oral↗
PubMed2004

Hypercalcemia of malignancy.

Less than 25 years ago tumor-induced hypercalcemia was often a lethal complication of cancer. Nowadays, it can be treated easily and successfully in at least 90% of cases by volume repletion in addition to the use of bisphosphonates that are potent anti-osteoclastic compounds. The standard therapy consists of the administration of 90 mg pamidronate or, more recently, 4 mg zoledronic acid, a more efficient bisphosphonate. When available, another alternative bisphosphonate is ibandronate. Recurrent hypercalcemia is nevertheless difficult to control and antibodies against parathyroid hormone-related protein could be useful for that matter in selected patients who are not in the terminal stage of their disease. Prevention of tumor-induced hypercalcemia is one of the objectives of long-term therapy with bisphosphonates in patients with tumor bone disease. The use of bisphosphonates in placebo-controlled trials has shown that the incidence of hypercalcemic episodes is reduced by more than one half.

Antineoplastic Agents↗
PubMed2003

[How to treat tumor-induced hypercalcemia].

Cancer hypercalcemia can now be easily and successfully treated in at least 90% of the cases. Standard therapy consists in rehydration and administration of bisphosphonates, namely pamidronate (90 mg), or more recently zoledronic acid (4 mg) which is more potent. When available, ibandronate constitutes an interesting alternative especially that this compound is apparently less nephrotoxic. Recurrent hypercalcemia remains difficult to control but often occurs in quite advanced stages of the neoplastic disease. In the future, antibodies against PTHrP could be useful in well selected patients. Prevention of cancer hypercalcemia is one of the objectives of long-term therapy with bisphosphonates in patients with bone metastases. They reduce the incidence of all complications of metastatic bone disease, including cancer hypercalcemia.

Diphosphonates↗
PubMed2003

Breast cancer patients with bone metastases are characterised by increased levels of nonisomerised type I collagen fragments.

BACKGROUND: Fragments of collagen type I containing the epitope AHDGGR (CTX) are generated during bone resorption. The aspartyl-glycine (DG) site within CTX is synthesised in the L-aspartyl peptide (alphaL) form, but converts to the age-modified forms L-isoaspartyl peptide (betaL) and D-aspartyl peptide (alphaD) over time. The purpose of the present study was to test the ability of the various CTX forms to identify breast cancer patients with bone metastases and to investigate whether such patients had an altered CTX excretion pattern. METHODS: In this cross-sectional study we compared CTX excretion in healthy premenopausal and postmenopausal women with CTX levels in patients with breast cancer. The breast cancer cohort comprised eight hypercalcemic patients with bone metastases (HC+), 100 normocalcemic patients with bone metastases (NC+) and 15 normocalcemic patients without bone metastases (NC-). RESULTS: In HC+ patients and NC+ patients, the excretion of alphaL CTX was highly increased compared with NC- patients (P < 0.01), with Z scores of 3.4 and 2.0, respectively. The excretion of the age-modified forms (betaL and alphaD CTX) was less increased in HC+ patients and in NC+ patients as compared with NC- patients, with Z scores of 2.2 and 1.0, respectively, for betaL CTX, and of 1.6 and 0.8, respectively, for alphaD CTX. CONCLUSION: Assays for the various isoforms of CTX have different sensitivities to identify patients affected by bone metastases. The alphaL CTX isoform reflecting resorption of young bone appeared to provide the best differentiation of patients affected by breast cancer-induced bone metastases. In conclusion, patients affected by metastatic bone disease present an altered excretion pattern of CTX isoforms.

Adult↗
PubMed2003

A phase I study of AMGN-0007, a recombinant osteoprotegerin construct, in patients with multiple myeloma or breast carcinoma related bone metastases.

BACKGROUND: Osteoprotegerin (OPG) is a decoy receptor for OPG ligand (OPGL), or receptor activator of NF-kappaB ligand (RANKL). RANKL/RANK interaction is important in terminal differentiation and activation of osteoclasts. In binding to RANKL, OPG blocks differentiation and activation of osteoclasts. AMGN-0007 is a recombinant OPG construct developed as a potential therapeutic agent in the treatment of bone disease. METHODS: A randomized, double-blind, double-dummy, active-controlled, single-dose, dose escalation study was conducted to determine the safety and effect on bone resorption of AMGN-0007 in patients with multiple myeloma (n = 28) or breast carcinoma (n = 26) with radiologically confirmed lytic bone lesions. Patients were randomized (3:1 ratio) to receive a single dose of either AMGN-0007 (subcutaneously [SC]) or pamidronate (90 mg intravenously) and were followed for 56 days. Medications or other diseases affecting bone metabolism and chemotherapy within 28 days of dosing were exclusion criteria. Biologic activity of AMGN-0007 was assessed by measurement of the surrogate marker of bone resorption, urinary N-telopeptide of collagen (NTX). RESULTS: AMGN-0007 caused a rapid, sustained, dose-dependent decrease in NTX/creatinine levels, which was at least comparable to the profile observed with pamidronate. Four serious adverse events were reported, three in breast carcinoma patients: a fracture in the left femur (pamidronate, considered unrelated), extreme fatigue (0.3 mg/kg AMGN-0007, considered unrelated), and congestive heart failure (1.0 mg/kg AMGN-0007, considered by the investigator to be probably related to doxorubicin and radiation therapy); one event occurred in a multiple myeloma patient: Herpes zoster (pamidronate, considered unrelated). Two multiple myeloma patients (1.0 mg/kg AMGN-0007) had albumin-adjusted serum calcium levels of 1.9 mmol/L on Day 8 but without clinical symptoms. CONCLUSIONS: A single SC dose of AMGN-0007 suppressed bone resorption as indicated by a rapid, sustained, and profound decrease of urinary NTX/creatinine in multiple myeloma and breast carcinoma patients. Changes were comparable to those with pamidronate. AMGN-0007 was well tolerated.

Antineoplastic Agents↗
PubMed2003

Effectiveness and cost of bisphosphonate therapy in tumor bone disease.

BACKGROUND: Tumor-induced osteolysis due to breast carcinoma and myeloma is responsible for a considerable morbidity that severely impairs patients'quality of life. Osteoclast-mediated bone resorption is reported to be increased markedly in patients with tumor bone disease and can be inhibited by bisphosphonate therapy. METHODS: The incidence of skeletal complications and the effectiveness of bisphosphonate therapy in patients with breast carcinoma metastatic to bone or in those with myeloma were derived from large-scale, long-term, placebo-controlled trials with clodronate or pamidronate. To the authors' knowledge, there are few studies published to date evaluating the cost-effectiveness of bisphosphonate therapy, and the majority that do exist often are based on models and are applicable only to a particular health care system. RESULTS: From the placebo groups of the above-mentioned trials, one can estimate that approximately 25-40% of the patients with breast carcinoma metastatic to bone will require radiotherapy for bone pain and approximately 17-50% will sustain incident vertebral fractures yearly. The incidence of complications is reported to be lower in myeloma patients. The prolonged administration of bisphosphonates reportedly can reduce the frequency of skeletal-related events by approximately 25-50%. Maximal efficacy appears to have been achieved with the current therapeutic schemes based on monthly intravenous infusions. Beneficial effects appear to be obtained more readily using the intravenous route rather than the oral route. The costs of bisphosphonate therapy appear to be higher than the cost savings from the prevention of skeletal-related events. The costs per quality of life-adjusted year have been estimated to be > $100,000, but more research is needed. Limited data suggest that zoledronic acid will not reduce treatment costs but the short infusion time will lead to substantial time savings for patients and for outpatient oncology facilities. CONCLUSIONS: As is the case for many agents used in oncology, bisphosphonates remain a relatively expensive therapy. More studies are needed to evaluate their cost-effectiveness ratio correctly. A ceiling effect has been reached with current therapeutic schemes and tailoring therapy to the individual patient needs to be evaluated correctly to increase therapeutic effectiveness and improve quality of life further without increasing treatment costs.

Bone Neoplasms↗
PubMed2003

Rationale for the use of bisphosphonates in osteoblastic and osteolytic bone lesions.

Various primary malignancies develop bone metastases, and the resultant skeletal complications cause significant morbidity/mortality in advanced cancer patients. Bone lesions associated with metastases are traditionally classified radiologically as either osteolytic or osteoblastic, and both types of lesions are associated with elevated levels of specific bone resorption markers. Some common aspects in the pathophysiology of bone lesions have prompted speculation that treatments for osteolytic metastases might also be effective for predominantly osteoblastic metastases, such as in prostate cancer. Potent osteoclast activity inhibitors, bisphosphonates have been successful in the treatment of osteolytic tumor bone disease. Zoledronic acid is the first bisphosphonate shown to have a direct clinical benefit in the treatment of osteoblastic bone metastases, reducing the number and rate of skeletal events in prostate cancer patients with metastatic bone disease. Moreover, the shorter, more convenient infusion time and similar safety profile of 4 mg zoledronic acid compared with 90 mg pamidronate presently make zoledronic acid the preferred therapy for treatment of bone metastases in patients with all types of advanced malignancy.

Bone Neoplasms↗
PubMed2003

Zoledronic acid: an advance in tumour bone disease therapy and a new hope for osteoporosis.

The two main therapeutic applications of bisphosphonates are tumour bone disease and osteoporosis. They constitute the standard treatment for cancer hypercalcaemia, and placebo-controlled trials have shown that the prolonged administration of bisphosphonates, such as pamidronate or clodronate, can reduce the frequency of complications from tumour bone disease due to metastatic breast cancer or myeloma by a quarter to one-half. The results obtained with the intravenous route appear to be more impressive and more rapidly obtained than with oral compounds. Both agents can reduce the risk of vertebral, wrist and hip fractures by 30 - 50%, whereas other antiresorptive agents, such as raloxifene (Eli Lilly & Co.) or calcitonin (Unigene Laboratories Inc.), have only been demonstrated to reduce the incidence of vertebral fractures. The short infusion time (4 mg over 15 min) offers a convenient therapy and constitutes the most evident advantage of zoledronic acid, which will improve patients' quality of life. Zoledronic acid has the potential to change the treatment of osteoporosis dramatically.

Animals↗
PubMed2003

Treatment of tumor-induced hypercalcemia: a solved problem?

Less than 25 years ago, tumor-induced hypercalcemia was often a lethal complication of cancer. Nowadays, it can be successfully and easily treated in at least 90% of the cases by rehydration and potent antiosteoclastic bisphosphonates. The standard therapy consists of the administration of 90 mg of pamidronate (Aredia Dry Powder) or more recently, 4 mg of zoledronic acid (Zometa)], which is even more efficient, at least in patients without bone metastases. Recurrent hypercalcemia is nevertheless difficult to control and antibodies against parathyroid-hormone-related protein may prove to be a useful treatment.

Humans↗
PubMed2002

Intravenous zoledronic acid in postmenopausal women with low bone mineral density.

BACKGROUND: Bisphosphonates are effective agents for the management of osteoporosis. Their low bioavailability and low potency necessitate frequent administration on an empty stomach, which may reduce compliance. Gastrointestinal intolerance limits maximal dosing. Although intermittent intravenous treatments have been used, the optimal doses and dosing interval have not been systematically explored. METHODS: We studied the effects of five regimens of zoledronic acid, the most potent bisphosphonate, on bone turnover and density in 351 postmenopausal women with low bone mineral density in a one-year, randomized, double-blind, placebo-controlled trial. Women received placebo or intravenous zoledronic acid in doses of 0.25 mg, 0.5 mg, or 1 mg at three-month intervals. In addition, one group received a total annual dose of 4 mg as a single dose, and another received two doses of 2 mg each, six months apart. Lumbar-spine bone mineral density was the primary end point. RESULTS: There were similar increases in bone mineral density in all the zoledronic acid groups to values for the spine that were 4.3 to 5.1 percent higher than those in the placebo group (P<0.001) and values for the femoral neck that were 3.1 to 3.5 percent higher than those in the placebo group (P<0.001). Biochemical markers of bone resorption were significantly suppressed throughout the study in all zoledronic acid groups. Myalgia and pyrexia occurred more commonly in the zoledronic acid groups, but treatment-related dropout rates were similar to that in the placebo group. CONCLUSIONS: Zoledronic acid infusions given at intervals of up to one year produce effects on bone turnover and bone density as great as those achieved with daily oral dosing with bisphosphonates with proven efficacy against fractures, suggesting that an annual infusion of zoledronic acid might be an effective treatment for postmenopausal osteoporosis.

Aged↗