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Bisphosphonates in breast cancer.
1Academic Unit of Clinical Oncology, Yorkshire Cancer Research Centre, Weston Park Hospital, Sheffield, UK. r.e.coleman@sheffield.ac.uk
Summary
Bisphosphonates are crucial for preventing bone complications in breast cancer patients with bone metastases. Clinical trials confirm their effectiveness in reducing skeletal-related events, with zoledronic acid showing superior results.
Area of Science:
- Oncology
- Pharmacology
Background:
- Breast cancer is the most common cancer in women.
- Bone metastases occur in over half of advanced breast cancer patients.
- Bisphosphonates are the standard treatment for skeletal complications.
Purpose of the Study:
- To review the efficacy of bisphosphonates in preventing skeletal-related events (SREs) in breast cancer patients with bone metastases.
- To compare the effectiveness of different bisphosphonates.
Main Methods:
- Review of clinical trials investigating bisphosphonate therapy for breast cancer bone metastases.
- Analysis of composite endpoints including pathologic fracture, spinal cord compression, and bone surgery/radiation.
Main Results:
- Bisphosphonates significantly reduce the incidence of SREs compared to placebo.
- Zoledronic acid, pamidronate, clodronate, and ibandronate demonstrated efficacy.
- Zoledronic acid showed superior efficacy over pamidronate in reducing SREs.
Conclusions:
- Bisphosphonates are effective in reducing and preventing skeletal complications in breast cancer patients with bone metastases.
- Preclinical data suggest potential antitumour effects.
- Bisphosphonates may also be beneficial in the adjuvant setting.