Bisphosphonate use for the management of breast cancer patients with bone metastases: A survey of Canadian Medical Oncologists

Verma, Sunil; Kerr-Cresswell, D.; Dranitsaris, George; Charbonneau, Flay; Trudeau, Maureen; Yogendran, Geetha; Cesta, Annemarie; Clemons, Mark

doi:10.1007/s00520-004-0671-9

Cited by 21 publications

(17 citation statements)

References 13 publications

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“…At present, a "one size fits all" approach is used whereby most patients receive potent i.v. BPs every 3-4 weeks from the time of bone metastases diagnosis to death [13,14]. Strategies are needed to individualize BP use based on individual risk of an SRE [1,10].…”

Section: Discussionmentioning

confidence: 99%

Skeletal-related events (SREs) in breast cancer patients with bone metastases treated in the nontrial setting

Trinkaus

Simmons

Myers

et al. 2009

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The frequency of SREs in this study was significantly lower than that reported in clinical trials of i.v. BP use. The lower incidence of SREs in this setting could affect sample size calculations for future event-driven BP trials. While the greatest risk of SREs despite BP therapy appears to be in patients with osteoporosis and with metastatic disease confined to the skeleton, further prospective study is merited to confirm and characterize the impact of these risk factors on SRE development.

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Section: Discussionmentioning

confidence: 99%

Skeletal-related events (SREs) in breast cancer patients with bone metastases treated in the nontrial setting

Trinkaus

Simmons

Myers

et al. 2009

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“…In a survey of 100 medical oncologists across Canada about their use of bisphosphonates for breast cancer patients 46 would generally either continue the same or switch to an alternative bisphosphonate agent. The agents most frequently used as initial therapy were oral clodronate and IV pamidronate.…”

Section: Discussionmentioning

confidence: 99%

“…Of the 47% of women whose first distant relapse was to bone, 29% developed a skeletal-related complication 2 . Recently, a Danish population-based estimate of bone metastases and sres in women with newly diagnosed breast cancer from 1999 to 2007 8 found that 46.4% of those who developed bone metastases developed a sre over a median follow-up of 0.7 years after the bone lesion was diagnosed. The incidence of sres was highest in the first year after diagnosis-not surprising given that metastatic breast cancer often first presents as a sre.…”

Section: Introductionmentioning

confidence: 99%

Bone-Targeted Agents and Skeletal-Related Events in Breast Cancer Patients with Bone Metastases: The State of the Art

et al. 2012

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Most women with advanced breast cancer will develop bone metastases, which are associated with the development of skeletal-related events (sres) such as pathologic fractures and spinal cord compression. This article reviews the evolving definition and incidence of sres, the pathophysiology of bone metastases, and the key evidence for the safety and efficacy of the currently available systemic treatment options for preventing and delaying sres in the setting of breast cancer with bone metastases. The bisphosphonates are structural analogues of endogenous pyrophosphate; three of them (clodronate, pamidronate, and zoledronate) are currently approved for use in Canada in the setting of breast cancer with bone metastases. Denosumab is a fully human immunoglobulin G2 monoclonal antibody that binds to human rankl (receptor activator of nuclear factor κB ligand), thereby preventing osteoclast formation, function, and survival, and reducing cancer-induced destruction of bone. Denosumab has recently been approved in Canada for reducing the risk of sres from the bone metastases associated with a variety of malignancies, including breast cancer. How to predict the patients that will benefit most from prophylactic treatment, the agents to select and the timing of switches between agents, the dosing schedules and durations of treatment to choose, the potential utility of the agents in the adjuvant setting, and the utility of additional endpoints such as markers of bone resorption are among the outstanding questions with respect to the optimal use of antiresorptive agents for patients with breast cancer and bone metastases.

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“…Because many patients continue on the same bisphosphonate indefinitely, irrespective of response failure, trials that evaluate the potentially beneficial effects of a change in therapy would be particularly valuable [58]. For example, oral clodronate can be problematic, since less than 5% of a dose of oral clodronate is absorbed.…”

Section: Can Bisphosphonate Therapy Reduce Ntx Levels?mentioning

confidence: 99%

Can bone markers guide more effective treatment of bone metastases from breast cancer?

Clemons

Cole

Gainford

2005

Breast Cancer Res Treat

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Bone metastases are a common problem for breast cancer patients, causing significant disease-related morbidity and mortality. Bisphosphonates and other cancer therapies can assist in managing these patients. However, assessing treatment efficacy in bone metastases is hampered by the inability to accurately measure disease response within a clinically desirable time frame. Bone-specific biochemical markers, notably type I collagen telopeptide cross-link by-products such as N-telopeptide (NTx) and C-telopeptide (CTx), have been shown to be effective tools for assessing the severity and extent of bone metastases, and the response to bisphosphonates. Elevated NTx levels correlate with adverse clinical outcomes. Normalization of NTx and CTx excretion rates are associated with relief of symptoms and a reduced incidence of skeletal-related events (SRE). This review discusses the expanding role of these bone markers in guiding treatment of bone metastases from breast cancer.

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Bisphosphonate use for the management of breast cancer patients with bone metastases: A survey of Canadian Medical Oncologists

Cited by 21 publications

References 13 publications

Skeletal-related events (SREs) in breast cancer patients with bone metastases treated in the nontrial setting

Skeletal-related events (SREs) in breast cancer patients with bone metastases treated in the nontrial setting

Bone-Targeted Agents and Skeletal-Related Events in Breast Cancer Patients with Bone Metastases: The State of the Art

Can bone markers guide more effective treatment of bone metastases from breast cancer?

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