[Tumor-induced hypercalcemia. Review of bisphosphonate treatment]

Rev Med Interne. 2001 Jul;22(7):648-52. doi: 10.1016/s0248-8663(01)00402-7.
[Article in French]

Abstract

Introduction: The incidence of tumor-induced hypercalcemia is between 10 to 20%. New treatments justify this review article.

Current knowledge and key points: Tumor-induced hypercalcemia (half of all hypercalcemia) is divided into two groups: hematological tumors (10%), and solid tumors (90%), with osteolytic hypercalcemia and humoral hypercalcemia of malignancy (HHM: mediators include PTHrP). The two most common causes of tumor-induced hypercalcemia are lung cancer and breast cancer. Tumor-induced hypercalcemia most commonly disturbs gastrointestinal, neurological, renal and cardiovascular functions. These symptoms may be erroneously attributed to the underlying malignancy or its therapy. Prognosis of tumor-induced hypercalcemia is very poor, with median survival being about 3 months. Bisphosphonates have emerged as the standard treatment of tumor-induced hypercalcemia. The intravenous administration of isotonic saline is the first step in the management of tumor-induced hypercalcemia. Specific treatment of cancer remains essential to prevent TIH relapse.

Future prospects and projects: New bisphosphonates have appeared, the most potent known bisphosphonate today is zoledronate.

Publication types

  • Review

MeSH terms

  • Diagnosis, Differential
  • Diagnostic Errors
  • Diphosphonates / pharmacology
  • Diphosphonates / therapeutic use*
  • Etidronic Acid / therapeutic use
  • Fluid Therapy / methods
  • Hematologic Neoplasms / complications*
  • Humans
  • Hypercalcemia / blood
  • Hypercalcemia / diagnosis
  • Hypercalcemia / drug therapy*
  • Hypercalcemia / etiology*
  • Imidazoles / therapeutic use
  • Neoplasms / complications*
  • Pamidronate
  • Prognosis
  • Recurrence
  • Sodium Chloride / therapeutic use
  • Treatment Outcome
  • Zoledronic Acid

Substances

  • Diphosphonates
  • Imidazoles
  • Sodium Chloride
  • Zoledronic Acid
  • Etidronic Acid
  • Pamidronate