Researchers evaluated the efficacy and safety of denosumab compared to zoledronic acid in treating advanced cancer with bone metastasis. Extensive literature searches in MEDLINE, EMBASE, and the Cochrane library databases were conducted, leading to the inclusion of four randomized controlled trials encompassing 7,201 patients. The study focused on various clinical outcomes, including time to first and subsequent skeletal-related events, overall survival, and disease progression. Additionally, safety outcomes like the incidence of adverse events, serious adverse events, acute-phase reactions, renal toxicity, osteonecrosis of the jaw, and hypocalcemia were analyzed.

The results revealed that denosumab is superior to zoledronic acid in delaying both the first skeletal-related event and the first-and-subsequent skeletal-related events. Denosumab showed a lower incidence of renal toxicity and acute phase reactions but had a higher incidence of hypocalcemia and osteonecrosis of the jaw. No significant differences were observed between the two drugs regarding overall survival, disease progression, and the incidence of adverse or serious adverse events. The study suggests that denosumab could be a more effective treatment option for advanced cancer with bone metastasis, although further randomized controlled trials are recommended for a more comprehensive evaluation.

Reference: Jiang L, Cui X, Ma H, Tang X. Comparison of denosumab and zoledronic acid for the treatment of solid tumors and multiple myeloma with bone metastasis: a systematic review and meta-analysis based on randomized controlled trials. J Orthop Surg Res. 2021 Jun 22;16(1):400. doi: 10.1186/s13018-021-02554-8. PMID: 34158101; PMCID: PMC8218501.