Use of monthly oral ibandronate to prevent anastrozole-induced bone loss during adjuvant treatment for breast cancer: Two-year results from the ARIBON study

Lester, J.; Purohit, O.P.; Gutcher, S. A.; Ellis, Sue; Thorpe, R.; Horsman, Janet; Brown, Janet; Hannon, Rosemary A.; Coleman, RE

doi:10.1200/jco.2008.26.15_suppl.554

Cited by 17 publications

(14 citation statements)

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“…Several studies have reported that intravenous zoledronic acid, given at an investigational dosing regimen of 4 mg twiceyearly, is effective at increasing BMD in women receiving adjuvant AIs [20][21][22]. Emerging data from studies with oral bisphosphonates have also shown improvements in BMD [23][24][25].…”

Section: Discussionmentioning

confidence: 99%

Effect of denosumab on bone mineral density in women receiving adjuvant aromatase inhibitors for non-metastatic breast cancer: subgroup analyses of a phase 3 study

Ellis

Bone²,

Chlebowski

et al. 2009

Breast Cancer Res Treat

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Denosumab increased lumbar spine bone mineral density (BMD) versus placebo in a 2-year, randomized, placebo-controlled, phase 3 study of patients with hormone-receptor-positive, non-metastatic breast cancer and low bone mass who were receiving adjuvant aromatase inhibitor therapy. In subgroup analyses at 12 and 24 months, we evaluated factors (duration and type of aromatase inhibitor, tamoxifen use, age, time since menopause, body mass index, T-score) that might influence BMD at the lumbar spine, total hip, femoral neck, and 1/3 radius. Patients were randomized to receive placebo (n = 125) or 60 mg denosumab (n = 127) subcutaneously every 6 months. In all subgroups, 12 or 24 months' treatment with denosumab was associated with larger BMD gains than placebo across multiple skeletal sites. Most increases were statistically significant (P < 0.05). Twice-yearly administration of denosumab, regardless of patient subgroup or skeletal site, resulted in consistent increases in BMD versus placebo at 12 and 24 months.

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Section: Discussionmentioning

confidence: 99%

Effect of denosumab on bone mineral density in women receiving adjuvant aromatase inhibitors for non-metastatic breast cancer: subgroup analyses of a phase 3 study

Ellis

Bone²,

Chlebowski

et al. 2009

Breast Cancer Res Treat

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“…In this setting, the disturbance of bone turnover is more similar to that seen in postmenopausal bone loss and doses, and schedules of bisphosphonate treatment that are similar to those used in osteoporosis are sufficient. Intravenous zoledronic acid every 6 months (Gnant et al, 2007), monthly oral Risks and benefits of bisphosphonates RE Coleman ibandronate (Lester et al, 2007) and weekly oral risedronate have all been shown to prevent bone loss associated with the use of aromatase inhibitors for postmenopausal breast cancer. In the context of androgen-deprivation therapy, zoledronic acid every 3 -12 months is able to prevent the bone loss associated with therapy (Smith et al, 2003;Michaelson et al, 2007).…”

Section: Treatment Benefitsmentioning

confidence: 99%

Risks and benefits of bisphosphonates

2008

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Bone is the most common site for metastasis in cancer and is of particular clinical importance in breast and prostate cancers due to the prevalence of these diseases. Bone metastases result in considerable morbidity and complex demands on health care resources, affecting quality of life and independence over years rather than months. The bisphosphonates have been shown to reduce skeletal morbidity in multiple myeloma as well as a wide range of solid tumours affecting bone by 30 -50%. Quite appropriately, these agents are increasingly used alongside anticancer treatments to prevent skeletal complications and relieve bone pain. The use of bisphosphonates in early cancer is also increasingly important to prevent the adverse effects of cancer treatments on bone health. These include ovarian suppression and the use of aromatase inhibitors in breast cancer patients and androgen deprivation therapy in those with prostate cancer. Bisphosphonate strategies, similar to those used to treat postmenopausal osteoporosis, have suggested that bisphosphonates are a safe and effective treatment for the prevention of treatment-induced bone loss. When compared to other cancer therapies, the frequency and severity of adverse events related to bisphosphonate therapy are generally mild and infrequent; thus, the benefits of treatment with any bisphosphonate almost always outweigh the risks. However, renal dysfunction may occasionally occur and over recent years, a new entity, bisphosphonate-associated osteonecrosis of the jaw (ONJ), has been described. The incidence, clinical importance and prevention strategies to minimise the impact of this problem on patients requiring bisphosphonates is discussed. British Journal of Cancer (2008) Bone is a common site for metastasis in patients with solid tumours arising from the breast, prostate, lung, thyroid and kidney . Approximately 70% of patients with advanced prostate cancer or breast cancer and up to 40% of patients with other advanced solid tumours will develop bone metastases. Additionally, in more than 50% of men with advanced prostate cancer and around 20% of women with advanced breast cancer, metastatic disease appears clinically confined to the skeleton.Bone metastases are typically referred to as osteoblastic, osteolytic or mixed, based on the radiographic appearance of the lesions. However, osteoblastic and osteolytic bone lesions represent two extremes of a spectrum and osteoclast activity is increased in most bone metastases, including the typical osteoblastic metastases from prostate cancer (Coleman, 2006). Pathological activation of osteoclasts appears to play a central role in most disease-related skeletal complications and is, thus, a rational therapeutic target and the basis for the use of bisphosphonates across the range of cancers affecting bone (Dunstan et al, 2007).Metastatic bone disease disrupts the normal homeostasis of bone, a dynamic process that involves the coupled and balanced osteoclast-mediated osteolysis and osteogenesis by osteoblasts (Coleman, 2006). The re...

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“…The Anastrozole-Induced Bone Loss During Adjuvant Treatment for Breast Cancer (ARIBON) trial used a similar design (patients with a T-score of −1.0 to −2.5 were randomized to either oral ibandronate or placebo). In that study, the addition of ibandronate to anastrozole led to a significant increase in BMD at the spine and hip after 1 year of therapy [13].…”

Section: Aromatase Inhibitor-induced Bone Lossmentioning

confidence: 97%

Bone Disease in Breast Cancer: The Era of New Targeted Therapies

Korde

Gralow

2010

Curr Breast Cancer Rep

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Breast cancer is the most common malignancy among women in the United States. Treatments for breast cancer can have significant effects on bone. Chemotherapy use in premenopausal women often leads to premature menopause, resulting in accelerated loss of bone mineral density. Hormonal therapy, particularly aromatase inhibitors in postmenopausal women, can also decrease bone density. In addition, a majority of patients with metastatic breast cancer have bony involvement, leading to bone pain, increased risk of fracture, and other morbidities. Thus, a thorough understanding of factors associated with cancer therapy-induced bone loss and treatment options are essential to providing quality care to cancer survivors. This article summarizes risk factors, evaluation, and treatment options for cancer therapy-induced bone loss and metastatic bone disease in breast cancer. In addition, emerging data regarding new targeted therapies and the effect of bonetargeted agents on breast cancer recurrence are discussed.

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Use of monthly oral ibandronate to prevent anastrozole-induced bone loss during adjuvant treatment for breast cancer: Two-year results from the ARIBON study

Cited by 17 publications

References 0 publications

Effect of denosumab on bone mineral density in women receiving adjuvant aromatase inhibitors for non-metastatic breast cancer: subgroup analyses of a phase 3 study

Effect of denosumab on bone mineral density in women receiving adjuvant aromatase inhibitors for non-metastatic breast cancer: subgroup analyses of a phase 3 study

Risks and benefits of bisphosphonates

Bone Disease in Breast Cancer: The Era of New Targeted Therapies

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