{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T22:06:24Z","timestamp":1789423584621,"version":"build-2803163510"},"reference-count":21,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"9","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Oncol Pract"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>PURPOSE<\/jats:title>\n                    <jats:p>The difference in time to serum calcium normalization and rates of subsequent refractory hypocalcemia between bisphosphonates requires further investigation. Our primary objective was to assess the difference in normalization of serum calcium between pamidronate and zoledronic acid during treatment of hypercalcemia of malignancy (HCM) and rates of subsequent, refractory hypocalcemia following therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>A retrospective review of patients with cancer who received pamidronate or zoledronic acid inpatient at Mayo Clinic for treatment of HCM between January 2018 and January 2024 was conducted. Logistic regression evaluated the association between treatment groups and outcomes. Multivariable modeling was adjusted for baseline differences, including severity of hypercalcemia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      We evaluated 856 patients. The median age was 68 (IQR, 59-75) years, and 476 (55.6%) were male. The most common cancer diagnoses were lymphoma (n = 158, 18.5%), followed by multiple myeloma (n = 145, 16.9%) and lung cancer (n = 111, 13%). Overall, 292 (46.8%) patients and 154 (32.8%) patients achieved serum calcium normalization by hospital day 4 and day 7, respectively. The rate of normalization was similar between all bisphosphonates, regardless of pamidronate dose. Significantly higher rates of hypocalcemia were observed on day 4 for patients who received zoledronic acid 4 mg once compared with either dose (60 mg once and 90 mg once) of pamidronate (40.7%\n                      <jats:italic toggle=\"yes\">v<\/jats:italic>\n                      27.6%\n                      <jats:italic toggle=\"yes\">v<\/jats:italic>\n                      26.8%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .049, respectively). No significant difference in rates of hypocalcemia were observed on day 7 (56.8%\n                      <jats:italic toggle=\"yes\">v<\/jats:italic>\n                      50%\n                      <jats:italic toggle=\"yes\">v<\/jats:italic>\n                      42.9%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .26, respectively) and day 30 (39.1%\n                      <jats:italic toggle=\"yes\">v<\/jats:italic>\n                      39.0%\n                      <jats:italic toggle=\"yes\">v<\/jats:italic>\n                      37.5%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .50, respectively).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>Bisphosphonates were equally efficacious in normalizing serum calcium in patients with HCM. Pamidronate 90 mg was not more efficacious than 60 mg. Rates of refractory hypocalcemia were similar.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/op-25-00543","type":"journal-article","created":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T20:59:29Z","timestamp":1763758769000},"page":"1663-1671","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy and Safety of Varied Bisphosphonate Therapy Dosing in Patients With Hypercalcemia of Malignancy"],"prefix":"10.1200","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9689-8123","authenticated-orcid":true,"given":"Sydney E.","family":"Schultz","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Mayo Clinic, Rochester, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2146-5766","authenticated-orcid":true,"given":"Jason N.","family":"Barreto","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Mayo Clinic, Rochester, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin C.","family":"Cole","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1576-8341","authenticated-orcid":true,"given":"Yucai","family":"Wang","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9668-6072","authenticated-orcid":true,"given":"Grace M.","family":"Choong","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Mayo Clinic, Rochester, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5651-1411","authenticated-orcid":true,"given":"Nelson","family":"Leung","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic, Rochester, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1200\/JOP.2016.011155"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.18331"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-112-7-499"},{"key":"e_1_3_6_5_2","article-title":"Malignancy-related hypercalcemia in advanced solid tumors: Survival outcomes","author":"Ramos REO","unstructured":"Ramos REO, Perez Mak M, Alves MFS, et al: Malignancy-related hypercalcemia in advanced solid tumors: Survival outcomes. 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East Hanover, NJ, Novartis Pharmaceuticals Corporation, 2012"},{"key":"e_1_3_6_20_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2001.19.2.558"},{"key":"e_1_3_6_21_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.4.5893.643"},{"key":"e_1_3_6_22_2","volume-title":"StatPearls","author":"Sadiq NM","year":"2025","unstructured":"Sadiq NM, Anastasopoulou C, Patel G, et al: Hypercalcemia, in StatPearls. 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