Value of Bisphosphonates
This is an article from Living Beyond Breast Cancer (www.lbbc.org) re a newsconference at the San Antonio meeting. Bisphosphonates are increasingly recommended both as adjuvant treatment and as part of the treatment for metastatic breast cancer.
SABCS Press Conference Explores the Benefits of Bisphosphonates in Breast Cancer
Reporters from renowned media outlets such as the Wall Street Journal, Associated Press, WebMD and NBC gathered today to listen to the first press conference organized by symposium officials, which looked at bisphosphonates and breast cancer.
Bisphosphonates, or bone-building or bone-strengthening pills, are routinely given to postmenopausal women with breast cancer, but new data suggest that these agents may play a role in reducing breast cancer recurrence as well. The press conference featured five studies that analyzed the use of bisphosphonates in different women affected by breast cancer.
The first study, "The Effect of Zoledronic Acid on Aromatase Inhibitor-Associated Bone Loss in Postmenopausal Women with Early Breast Cancer Receiving Adjuvant Letrozole: The Z-FAST Study 5-Year Final Follow-Up," was presented at a poster session by Adam Brufsky, MD, PhD of the University of Pittsburgh Cancer Institute. The study found that zoledronic acid is both safe and effective in preventing bone loss in postmenopausal women with breast cancer who are treated with aromatase inhibitors. The investigator concluded that there were no serious effects on the kidneys and no osteonecrosis (deterioration of tissues) of the jaw, a concern of many women who take these medicines.
The second study, "Oral Bisphosphonate and Breast Cancer: Prospective Results from the Women's Health Initiative (WHI)," was presented during the opening general session by Rowan Chlebowski, MD, PhD, of the Los Angeles Biomedical Research Institute at Harbor-University of California, Los Angeles Medical Center. This study concluded that healthy postmenopausal women who used bisphosphonates had 32 percent fewer cases of invasive breast cance rcompared to women who did not use such medicines.
The third study, "Use of Bisphosphonates and Risk of Postmenopausal Breast Cancer," was presented during the general plenary by Gad Rennert, MD, PhD, of the Carmel Medical Center of Clalit Health Services and Technion-Israel institute of Technology in Israel. This study concluded that using bisphosphonates for more than one year was associated with a 29 percent reduction inthe risk of breast cancer in postmenopausal women.
"We have identified a new class of drugs that is associated with a reduced risk of breast cancer, and if proven in randomized trials, we may be able to recommend it to postmenopausal women for this purpose," Dr. Rennert said.
The fourth study, and one that I found to be very interesting, looked at bisphosphonates in women with advanced disease. The study, "A Comparison of Denosumab Versus Zoledronic Acid on the Incidence of Skeletal-Related Events in Breast Cancer Patients with Bone Metastases," was presented during the general session by Alison Stopeck, MD, of the University of Arizona Cancer Center. The study concluded that among people with bone metastasis from breast cancer, denosumab (brand name: Prolia) was superior to zoledronic acid in reducing the incidence of complications from bone metastases. Denosumab given as a monthly injection represents a potential treatment option for the management of bone metastases without the need for monitoring kidney function. Study participants who took denosumab saw fewer side effects compared to those who took zoledronic acid.
I asked Dr. Stopeck for her takeaway message from this study for women coping with metastatic disease."Better care will soon be available to you," she said. "[Denosumab will] help with your pain, prevent you from getting complications, and have less toxicity. My patients [on this trial] are loving it." Dr. Stopeck has been involved in this trial from its inception in 2006 and is hopeful denosumab will be available to everyone by this time next year.
The fifth and final study featured in the press conference, "Randomized Placebo Controlled Trial Studying Short Term Biological Effects of the Combination of Letrozole and Zoledronic Acid on Invasive Breast Cancer," was presented by Nigel J. Bundred, MD, of the University Hospital of South Manchester and the University of Manchester in the United Kingdom. The study concluded preoperative combination therapy with letrozole (brand name: Femara) and zoledronic acid is safe and effective. Letrozole is an oral, non-steroidal aromatase inhibitor used for treatment of local or metastatic breast cancer that is hormone receptor-positive. Zoledronic acid is used to prevent bone fractures in people with bone metastasis.