Adjuvant bisphosphonate treatment for breast cancer: why did something so elegant become so complicated?

Breast Cancer Research and Treatment
Mark ClemonsChristina L Addison

Abstract

Bisphosphonate therapy has revolutionized the care of patients with metastatic bone disease. With its demonstrated activity and anti-tumour effects in preclinical studies it was natural to transition these agents to testing in the adjuvant setting. Surprisingly, the results of adjuvant breast cancer trials have shown either modest or no benefit or even harm. We sought to explore whether there were specific patient cohorts or treatment strategies that were most likely to benefit from adjuvant bisphosphonate therapy. We compared trial designs, patient characteristics and outcomes from the six published and two presented randomized adjuvant bisphosphonate trials. Differences in trial design and patient populations make direct comparisons complicated. The most efficacious use of adjuvant bisphosphonates appears to be in patients with either biopsy evidence of osseous micrometastases, were post-menopausal or had estrogen receptor-positive tumours. Despite tremendous optimism regarding adjuvant bisphosphonate therapy, results from large trials are conflicting. Further investigation into factors influencing response to bisphosphonate treatment or selection of appropriate sub-groups of patients with desirable response characteristics i...Continue Reading

References

Jul 3, 1998·International Journal of Cancer. Journal International Du Cancer·A SasakiT Matsumura
Jul 31, 2008·Annals of Oncology : Official Journal of the European Society for Medical Oncology·I J DielF Schuetz
Aug 13, 2008·Journal of the National Cancer Institute·Penelope D OttewellIngunn Holen
Feb 18, 2010·British Journal of Cancer·P A NewcombJ M Hampton
Apr 1, 2010·Nature Reviews. Clinical Oncology·Eitan AmirMark Clemons
May 7, 2010·Annals of Oncology : Official Journal of the European Society for Medical Oncology·H EidtmannR Coleman
Jun 23, 2010·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Rowan T ChlebowskiRobert B Wallace
Jun 23, 2010·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Gad RennertHedy S Rennert
Feb 2, 2011·Bone·Serge Cremers, Socrates Papapoulos
Jun 7, 2011·The Lancet Oncology·Michael GnantUNKNOWN Austrian Breast and Colorectal Cancer Study Group, Vienna, Austria
Oct 15, 2011·The New England Journal of Medicine·Robert E ColemanUNKNOWN AZURE Investigators

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Citations

Mar 29, 2014·Expert Opinion on Pharmacotherapy·Carmel JacobsMark Clemons
Jan 1, 2013·Journal of Clinical Medicine·Demetrios SimosMark Clemons
Aug 16, 2021·BMC Cancer·Christine StürkenVolkmar Müller

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