In all three studies overall survival was balanced between XGEVA and zoledronic acid in patients with advanced malignancies involving bone: patients with breast cancer (hazard ratio and 95% CI was [, ]), patients with prostate cancer (hazard ratio and 95% CI was [, ]), and patients with other solid tumours or multiple myeloma (hazard ratio and 95% CI was [, ]). A post-hoc analysis in study 2 (patients with other solid tumours or multiple myeloma) examined overall survival for the 3 tumour types used for stratification (non-small cell lung cancer, multiple myeloma, and other). Overall survival was longer for XGEVA in non-small cell lung cancer (hazard ratio [95% CI] of [, ]; n = 702) and longer for zoledronic acid in multiple myeloma (hazard ratio [95% CI] of [, ]; n = 180) and similar between XGEVA and zoledronic acid in other tumour types (hazard ratio [95% CI] of (, ); n = 894). This study did not control for prognostic factors and anti-neoplastic treatments. In a combined pre-specified analysis from studies 1, 2 and 3, overall survival was similar between XGEVA and zoledronic acid (hazard ratio and 95% CI [, ]).
Figure A shows a lytic destructive lesion in the vertebral body. Figure B shows multiple plasma cells. Multiple myeloma is a neoplastic process involving the proliferation of plasma cells. It is often associated with anemia, chronic pain, low-grade fevers, and skeletal lesions that are often "cold" on bone scans.
Weber showed that the main differential diagnosis for a patient older than 40 with a destructive bone lesion should include metastatic bone disease, multiple myeloma, lymphoma, and, less commonly, primary bone tumors.