Bisphosphonates and Bone Turnover in Premenopausal Women Receiving Adjuvant Chemotherapy

Paterson, Alexander; Baker, Thomas W.

doi:10.1200/jco.2008.20.4057

Cited by 8 publications

(6 citation statements)

References 17 publications

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“…In this study, the median PFS for capecitabine (9.2 months) was better than the PFS seen in previous studies (4.1 to 7.7 months) [1-5]. The median PFS for taxanes (7.8 months) was in keeping with previous studies (3.6–12.9 months) [5, 9–14]. Similarly, the median PFS for anthracyclines (8 months) was in keeping with previous studies (3.1–11 months) [5–10].…”

Section: Discussioncontrasting

confidence: 72%

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Assessing the tolerability and efficacy of first-line chemotherapy in elderly patients with metastatic HER2−ve breast cancer

Wilson

Dyke

Reed

et al. 2019

ecancer

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Background In metastatic breast cancer (MBC), there is no consensus regarding the optimal regimen sequence and whether adults >65 years old (OA) are at increased risk from chemotherapy toxicity. Treatment decisions are often driven by the ability to tolerate treatment and maintain the quality of life. This study was designed to assess current practice in an oncology hospital in the UK. Methods Retrospective data were collected about treatments used for 87 OA with MBC in a single centre between 2009 and 2016 to assess the tolerability and efficacy of first-line chemotherapy. Student’s T-tests and Kaplan-Meier statistical methods were applied. Results 70% of patients were commenced on standard dose (SD) of chemotherapy; 84% (21/25) of the anthracycline group (AG), 65% (20/31) of the capecitabine group (CG), 48% (10/21) of the taxane group (TG) and 100% (10/10) of other agents. 32% of patients had dose reductions; 16% in AG, 19% in TG and 58% in CG. Overall 30% of patients received six cycles of SD of chemotherapy; 36% in AG, 29% in CG and 14% in TG. 23% of patients suffered ≥grade 3 toxicity; 28% in AG, 29% in CG and 10% in TG. There were four treatment-related deaths; two in AG and one in both CG and TG. 61% of the CG received 6+ cycles with a mean on treatment time of 445 days (1–2,150). There was no statistical significance in progression- free survival (PFS) between groups. The median PFS for all patients was 244 days (87–381). Performance status, haemoglobin and estimated glomerular filtration rates prior to starting chemotherapy were all useful in predicting PFS. Conclusions A relevant number of patients required dose reduction but dose-reduced chemotherapy was tolerated well. Anthracycline-based regimens were used in patients who had not received adjuvant chemotherapy. Capecitabine required the most dose reductions. Taxanes were generally started at reduced doses, resulting in fewer grade 3+ toxicities. As well as age, underlying physiological reserve, current performance status and co-morbidities should guide physicians who should consider lower starting doses in OA and recognise that dose reductions may be required to improve tolerability. The PFS of all regimens were similar in this study. This study highlights the need for further research to define the optimal first-line chemotherapy and starting dose in OA with MBC.

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Section: Discussioncontrasting

confidence: 72%

“…The median PFS for all groups was generally better than those seen in previous studies [1–14]. In this study, the median PFS for capecitabine (9.2 months) was better than the PFS seen in previous studies (4.1 to 7.7 months) [1-5]. The median PFS for taxanes (7.8 months) was in keeping with previous studies (3.6–12.9 months) [5, 9–14].…”

Section: Discussioncontrasting

confidence: 50%

Assessing the tolerability and efficacy of first-line chemotherapy in elderly patients with metastatic HER2−ve breast cancer

Wilson

Dyke

Reed

et al. 2019

ecancer

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“…The available antiresorptive therapies using bisphosphonates are known to reduce resorption and increase bone mass and thus have some efficacy in preventing/reducing osteoporosis (17). A review (34) has indicated that there have been attempts at using bisphosphonates to ameliorate the possible side effects of cancer-induced or treatment-induced bone loss. However, one study has shown that there were no significant changes in terms of bone loss between the treatment groups receiving oral risedronate or placebo, which has called into question the correct dosing of bisphosphonates (16).…”

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confidence: 99%

“…However, one study has shown that there were no significant changes in terms of bone loss between the treatment groups receiving oral risedronate or placebo, which has called into question the correct dosing of bisphosphonates (16). The review (34) has also mentioned that bisphosphonates inhibit the formation of new bone as well as bone resorption and that the increase in bone density seen in some studies involving the use of bisphosphonates might be due to the increased mineralization of the old bone and inhibition of the new soft bone. However, high costs involved in their administration and occasional toxicities and side effects, including brittle bones due to suppressed bone turnover, have limited their widespread usage, and the cost-effectiveness of their usage or long-term use has been questioned (9,33).…”

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confidence: 99%

Dietary emu oil supplementation suppresses 5-fluorouracil chemotherapy-induced inflammation, osteoclast formation, and bone loss

Nadhanan

Abimosleh

et al. 2012

American Journal of Physiology-Endocrinology and Metabolism

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Raghu Nadhanan R, Abimosleh SM, Su YW, Scherer MA, Howarth GS, Xian CJ. Dietary emu oil supplementation suppresses 5-fluorouracil chemotherapy-induced inflammation, osteoclast formation, and bone loss. Am J Physiol Endocrinol Metab 302: E1440 -E1449, 2012. First published March 20, 2012; doi:10.1152/ajpendo.00587.2011Cancer chemotherapy can cause osteopenia or osteoporosis, and yet the underlying mechanisms remain unclear, and currently, no preventative treatments are available. This study investigated damaging effects of 5-fluorouracil (5-FU) on histological, cellular, and molecular changes in the tibial metaphysis and potential protective benefits of emu oil (EO), which is known to possess a potent anti-inflammatory property. Female dark agouti rats were gavaged orally with EO or water (1 ml·day Ϫ1 ·rat Ϫ1 ) for 1 wk before a single ip injection of 5-FU (150 mg/kg) or saline (Sal) was given. The treatment groups were H2O ϩ Sal, H2O ϩ 5-FU, EO ϩ 5-FU, and EO ϩ Sal. Oral gavage was given throughout the whole period up to 1 day before euthanasia (days 3, 4, and 5 post-5-FU). Histological analysis showed that H2O ϩ 5-FU significantly reduced heights of primary spongiosa on days 3 and 5 and trabecular bone volume of secondary spongiosa on days 3 and 4. It reduced density of osteoblasts slightly and caused an increase in the density of osteoclasts on trabecular bone surface on day 4. EO supplementation prevented reduction of osteoblasts and induction of osteoclasts and bone loss caused by 5-FU. Gene expression studies confirmed an inhibitory effect of EO on osteoclasts since it suppressed 5-FU-induced expression of proinflammatory and osteoclastogenic cytokine TNF␣, osteoclast marker receptor activator of nuclear factor-B, and osteoclast-associated receptor. Therefore, this study demonstrated that EO can counter 5-FU chemotherapy-induced inflammation in bone, preserve osteoblasts, suppress osteoclast formation, and potentially be useful in preventing 5-FU chemotherapy-induced bone loss.receptor activator of nuclear factor-B ligand; tumor necrosis factor-␣; anti-inflammatory ANTI-CANCER CHEMOTHERAPY can cause significant adverse effects on tissues, including the bone, in both pediatric and adult cancer patients (25). Short stature, low bone mass or osteoporosis, and/or fractures are some skeletal side effects that are due to chemotherapy among pediatric patients and adult survivors (32, 38, 46). Experimental studies in rats have also shown that drugs such as methotrexate (MTX), cisplatin, doxorubicin, etoposide, cyclophosphamide, and 5-fluorouracil (5-FU) can cause a reduction in bone growth and bone mass (50 -52). 5-FU is an antimetabolite drug commonly used to treat adult patients suffering from colorectal and breast cancer, whereas in children 5-FU is used to treat childhood solid tumours (27, 36). 5-FU inhibits thymidylate synthase, an enzyme required to synthesize thymine nucleotide, which is important for synthesis of DNA and RNA (27). In an acute 5-FU chemotherapy model in rats, reduced primary spongiosa heigh...

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“…The RIBBON-1 trial proved that bevacizumab increased PFS and overall response rate when compared to placebo when this agent was used with single agent taxanes, anthracycline-based regimes, and capecitabine [102]. A subset analysis of patients with TNBC demonstrated an improvement in PFS when bevacizumab was used both with capecitabine (6.1 vs. 4.2 months, HR = 0.72, 95% CI, 0.49-1.06).…”

Section: Therapymentioning

confidence: 99%

Treatment options for patients with triple-negative breast cancer

Santana-Dávila

Perez

2010

J Hematol Oncol

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Breast cancer is a heterogeneous disease composed of different subtypes, characterized by their different clinicopathological characteristics, prognoses and responses to treatment. In the past decade, significant advances have been made in the treatment of breast cancer sensitive to hormonal treatments, as well as in patients whose malignant cells overexpress or amplify HER2. In contrast, mainly due to the lack of molecular targets, little progress has been made in the treatment of patients with triple-negative breast cancer. Recent improved understanding of the natural history, pathophysiology, and molecular features of triple-negative breast cancers have provided new insights into management and therapeutic strategies for women affected with this entity. Ongoing and planned translational clinical trials are likely to optimize and improve treatment of women with this disease.

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Bisphosphonates and Bone Turnover in Premenopausal Women Receiving Adjuvant Chemotherapy

Cited by 8 publications

References 17 publications

Assessing the tolerability and efficacy of first-line chemotherapy in elderly patients with metastatic HER2−ve breast cancer

Assessing the tolerability and efficacy of first-line chemotherapy in elderly patients with metastatic HER2−ve breast cancer

Dietary emu oil supplementation suppresses 5-fluorouracil chemotherapy-induced inflammation, osteoclast formation, and bone loss

Treatment options for patients with triple-negative breast cancer

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