1527 Bone Targeting Agent (BTA) treatment patterns and the impact of Bone Metastases (BM) on prostate cancer patients in a real world setting

Body, J.J.; Henry, D.; Moos, Roger von; Rider, A.; Courcy, J. De; Murray, Graeme; Bhowmik, Debajyoti; Gatta, F; Arellano, Jorge; Hechmati, Guy; Qian, Yang

doi:10.1016/s0959-8049(16)30617-7

Cited by 2 publications

(5 citation statements)

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“…However, these guidelines report that the optimal timing for starting such osteoclast-targeted treatment, optimal treatment intensity (dose and frequency) and optimal treatment duration in men with CRPC is unclear [47]. Despite the lack of guidelines, evidence from real-world studies is emerging regarding the concurrent use of bisphosphonates or denosumab and new therapies [73]. Real-world treatment patterns of bisphosphonates or denosumab use across six EU countries have indicated that 74% (n = 1454) of 1971 patients with advanced prostate cancer and bone metastases were receiving one of these agents.…”

Section: Timing and Additional Considerations For Combination Therapymentioning

confidence: 99%

“…Real-world treatment patterns of bisphosphonates or denosumab use across six EU countries have indicated that 74% (n = 1454) of 1971 patients with advanced prostate cancer and bone metastases were receiving one of these agents. A large proportion of patients given a novel therapy were receiving concurrent treatment with bisphosphonates or denosumab: 75% (n = 335/449) of patients receiving AA, 67% (n = 99/148) of those receiving enzalutamide and 70% (n = 7/10) of those receiving radium-223 [73].…”

Section: Timing and Additional Considerations For Combination Therapymentioning

confidence: 99%

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The role of bisphosphonates or denosumab in light of the availability of new therapies for prostate cancer

Saad

Sternberg

Mulders

et al. 2018

Cancer Treatment Reviews

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Most men with advanced prostate cancer will develop bone metastases, which have a substantial impact on quality of life. Bone metastases can lead to skeletal-related events (SREs), which place a burden on patients and healthcare systems. For men with castration-resistant prostate cancer (CRPC) and bone metastases, the treatment landscape has evolved rapidly over the past few years. The relatively recent approvals of the hormonal agents abiraterone acetate and enzalutamide, second-line chemotherapy cabazitaxel, and the radiopharmaceutical radium-223 dichloride (radium-223), have provided clinicians with a greater choice of treatments. These compounds have benefits in terms of overall survival based on the results of pivotal phase 3 studies. The bisphosphonate zoledronic acid and the RANK ligand inhibitor denosumab are indicated for the prevention of SREs in men with metastatic CRPC but studies of these compounds have not demonstrated a survival benefit. The important question of the role of bisphosphonates or denosumab in combination with these new agents has thus materialised. Current and emerging evidence from clinical studies of abiraterone acetate, enzalutamide and radium-223, suggest that addition of bisphosphonates or denosumab to these new therapies may provide further clinical benefits for patients with prostate cancer and bone metastases. This evidence may help to shape clinical practice but are based largely on post hoc analyses of clinical trial data. It is therefore apparent that further data are required from both clinical studies and real-world settings to enable physicians to understand the efficacy and safety of combination therapy with the new agents plus bisphosphonates or denosumab.

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Section: Timing and Additional Considerations For Combination Therapymentioning

confidence: 99%

Section: Timing and Additional Considerations For Combination Therapymentioning

confidence: 99%

The role of bisphosphonates or denosumab in light of the availability of new therapies for prostate cancer

Saad

Sternberg

Mulders

et al. 2018

Cancer Treatment Reviews

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“…Clinical practice guidelines recommend using BTAs as soon as bone metastases are detected, and continuing use throughout the disease course [30]. In real-world settings, however, 19% of the patients with breast cancer and bone metastases did not receive a BTA until more than 3 months after bone metastases were detected [99], and for prostate cancer this proportion was even higher (28%) [100]. The main reasons for delaying treatment were a very recent diagnosis [99] and a perceived low risk of bone complications [100].…”

Section: Considerations For Use Of Btas: Applying Guidelines In Clinical Practicementioning

confidence: 99%

“…The optimal duration of BTA therapy is not completely defined by ESMO, but continuous treatment is recommended in patients with progression of underlying bone metastases, a recent SRE and/or elevated bone resorption markers [30]. In real-world practice, unplanned discontinuations may occur owing to hypocalcaemia, risk and presence of osteonecrosis of the jaw and primary tumour progression [99,100]. A considerable proportion of patients may also stop receiving BTAs owing to completion of planned treatment [99,100]; indeed, in a large patient chart survey, the most common reason for discontinuation was reaching the end of planned treatment [102].…”

Section: Considerations For Use Of Btas: Applying Guidelines In Clinical Practicementioning

confidence: 99%

“…In real-world practice, unplanned discontinuations may occur owing to hypocalcaemia, risk and presence of osteonecrosis of the jaw and primary tumour progression [99,100]. A considerable proportion of patients may also stop receiving BTAs owing to completion of planned treatment [99,100]; indeed, in a large patient chart survey, the most common reason for discontinuation was reaching the end of planned treatment [102]. This implies that, despite the lack of guidance, physicians tend to determine treatment course length when prescribing BTAs.…”

Section: Considerations For Use Of Btas: Applying Guidelines In Clinical Practicementioning

confidence: 99%

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Improving quality of life in patients with advanced cancer: Targeting metastatic bone pain

Moos

Costa

Ripamonti

et al. 2017

European Journal of Cancer

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Metastatic bone disease in patients with advanced cancer is frequently associated with skeletal complications. These can be debilitating, causing pain, impaired functioning and decreased quality of life, as well as reduced survival. This review considers how the management of metastatic bone pain might be optimised, to limit the considerable burden it can impose on affected patients. Cancer-related pain is notoriously under-reported and under-treated, despite the availability of many therapeutic options. Non-opioid and opioid analgesics can be used; the latter are typically administered with radiotherapy, which forms the current standard of care for patients with metastatic bone pain. Surgery is appropriate for certain complicated cases of metastatic bone disease, and other options such as radiopharmaceuticals may provide additional relief. Treatments collectively referred to as bone-targeted agents (BTAs; bisphosphonates and denosumab) can offer further pain reduction. Initiation of therapy with BTAs is recommended for all patients with metastatic bone disease because these agents delay not only the onset of skeletal-related events but also the onset of bone pain. With evidence also emerging for pain control properties of new anticancer agents, the potential to individualise care for these patients is increased further. Optimisation of care depends on physicians' thorough appreciation of the complementary benefits that might be achieved with the various agents, as well as their limitations. Appropriate anti-tumour treatment combined with early initiation of BTAs and adequate analgesia plays a key role in the holistic approach to cancer pain management and may minimise the debilitating effects of metastatic bone pain.

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1527 Bone Targeting Agent (BTA) treatment patterns and the impact of Bone Metastases (BM) on prostate cancer patients in a real world setting

Cited by 2 publications

References 0 publications

The role of bisphosphonates or denosumab in light of the availability of new therapies for prostate cancer

The role of bisphosphonates or denosumab in light of the availability of new therapies for prostate cancer

Improving quality of life in patients with advanced cancer: Targeting metastatic bone pain

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