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Published in: Supportive Care in Cancer 10/2016

01-10-2016 | Commentary

Breast cancer and bone metastases: a call for appropriate treatment

Authors: Diana Lüftner, Daniela Niepel

Published in: Supportive Care in Cancer | Issue 10/2016

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Abstract

Purpose

The aim of this study is to provide an overview of the potential barriers to uptake of bone-targeted agents for the prevention of skeletal-related events (SREs) in patients with breast cancer and bone metastases.

Methods

A top-line literature review was conducted to identify trends in and barriers to initiating bone-targeted therapy in patients with metastatic breast cancer.

Results

The majority of patients with bone metastases that are secondary to breast cancer clearly benefit from treatment with a bone-targeted agent such as the RANK ligand inhibitor denosumab or the bisphosphonate zoledronic acid, because both delay the onset of SREs. Evidence suggests, however, that these agents are not being used in these patients as per European guideline recommendations.

Conclusions

Adoption of a number of behavioral changes may help to overcome barriers to earlier initiation of treatment with bone-targeted agents in these patients. This includes raising awareness of the guidelines that are available for bone-targeted therapies, providing physician and patient education on the appropriate use of these agents, and highlighting to physicians the importance of early treatment and regular monitoring for adverse events. Earlier initiation of treatment should help to reduce the risk of SREs and thus lessen the burden that these debilitating skeletal complications place on patients and healthcare systems.
Literature
1.
go back to reference Costa L, Badia X, Chow E, Lipton A, Wardley A (2008) Impact of skeletal complications on patients’ quality of life, mobility, and functional independence. Support Care Cancer 16(8):879–889CrossRefPubMed Costa L, Badia X, Chow E, Lipton A, Wardley A (2008) Impact of skeletal complications on patients’ quality of life, mobility, and functional independence. Support Care Cancer 16(8):879–889CrossRefPubMed
2.
go back to reference Stopeck AT, Lipton A, Body JJ, Steger GG, Tonkin K, de Boer RH, Lichinitser M, Fujiwara Y, Yardley DA, Viniegra M, Fan M, Jiang Q, Dansey R, Jun S, Braun A (2010) Denosumab compared with zoledronic acid for the treatment of bone metastases in patients with advanced breast cancer: a randomized, double-blind study. J Clin Oncol 28(35):5132–5139CrossRefPubMed Stopeck AT, Lipton A, Body JJ, Steger GG, Tonkin K, de Boer RH, Lichinitser M, Fujiwara Y, Yardley DA, Viniegra M, Fan M, Jiang Q, Dansey R, Jun S, Braun A (2010) Denosumab compared with zoledronic acid for the treatment of bone metastases in patients with advanced breast cancer: a randomized, double-blind study. J Clin Oncol 28(35):5132–5139CrossRefPubMed
3.
go back to reference Coleman R, Body JJ, Aapro M, Hadji P, Herrstedt J, Group EGW (2014) Bone health in cancer patients: ESMO Clinical Practice Guidelines. Ann Oncol 25(Suppl 3):iii124–iii137CrossRefPubMed Coleman R, Body JJ, Aapro M, Hadji P, Herrstedt J, Group EGW (2014) Bone health in cancer patients: ESMO Clinical Practice Guidelines. Ann Oncol 25(Suppl 3):iii124–iii137CrossRefPubMed
4.
go back to reference Casas A, Flinois A, Schoen P, Shepherd S, Haynes I (2013) Management of bone metastases secondary to breast cancer: a comprehensive survey of practice patterns in five European countries. Eur J Cancer 49(suppl 2):abstr 1880 Casas A, Flinois A, Schoen P, Shepherd S, Haynes I (2013) Management of bone metastases secondary to breast cancer: a comprehensive survey of practice patterns in five European countries. Eur J Cancer 49(suppl 2):abstr 1880
5.
go back to reference Oster G, Lamerato L, Glass AG, Richert-Boe KE, Lopez A, Chung K, Richhariya A, Dodge T, Wolff GG, Balakumaran A, Edelsberg J (2014) Use of intravenous bisphosphonates in patients with breast, lung, or prostate cancer and metastases to bone: a 15-year study in two large US health systems. Support Care Cancer 22(5):1363–1673CrossRefPubMed Oster G, Lamerato L, Glass AG, Richert-Boe KE, Lopez A, Chung K, Richhariya A, Dodge T, Wolff GG, Balakumaran A, Edelsberg J (2014) Use of intravenous bisphosphonates in patients with breast, lung, or prostate cancer and metastases to bone: a 15-year study in two large US health systems. Support Care Cancer 22(5):1363–1673CrossRefPubMed
6.
go back to reference Lüftner D (2015) Clinical practice guidelines for breast cancer: current limitations. Breast J 21(4):450–453CrossRefPubMed Lüftner D (2015) Clinical practice guidelines for breast cancer: current limitations. Breast J 21(4):450–453CrossRefPubMed
9.
go back to reference Launay-Vacher V, Gligorov J, Le Tourneau C, Janus N, Spano JP, Ray-Coquard I, Oudard S, Pourrat X, Morere JF, Deray G, Beuzeboc P (2010) Prevalence of renal insufficiency in breast cancer patients and related pharmacological issues. Breast Cancer Res Treat 124(3):745–1653CrossRefPubMed Launay-Vacher V, Gligorov J, Le Tourneau C, Janus N, Spano JP, Ray-Coquard I, Oudard S, Pourrat X, Morere JF, Deray G, Beuzeboc P (2010) Prevalence of renal insufficiency in breast cancer patients and related pharmacological issues. Breast Cancer Res Treat 124(3):745–1653CrossRefPubMed
10.
go back to reference Jamal SA, Ljunggren O, Stehman-Breen C, Cummings SR, McClung MR, Goemaere S, Ebeling PR, Franek E, Yang YC, Egbuna OI, Boonen S, Miller PD (2011) Effects of denosumab on fracture and bone mineral density by level of kidney function. J Bone Miner Res 26(8):1829–1635CrossRefPubMed Jamal SA, Ljunggren O, Stehman-Breen C, Cummings SR, McClung MR, Goemaere S, Ebeling PR, Franek E, Yang YC, Egbuna OI, Boonen S, Miller PD (2011) Effects of denosumab on fracture and bone mineral density by level of kidney function. J Bone Miner Res 26(8):1829–1635CrossRefPubMed
11.
go back to reference Tanvetyanon T, Stiff PJ (2006) Management of the adverse effects associated with intravenous bisphosphonates. Ann Oncol 17(6):897–907CrossRefPubMed Tanvetyanon T, Stiff PJ (2006) Management of the adverse effects associated with intravenous bisphosphonates. Ann Oncol 17(6):897–907CrossRefPubMed
12.
go back to reference Body JJ, Bone HG, de Boer RH, Stopeck A, Van Poznak C, Damiao R, Fizazi K, Henry DH, Ibrahim T, Lipton A, Saad F, Shore N, Takano T, Shaywitz AJ, Wang H, Bracco OL, Braun A, Kostenuik PJ (2015) Hypocalcaemia in patients with metastatic bone disease treated with denosumab. Eur J Cancer 51(13):1812–1821CrossRefPubMed Body JJ, Bone HG, de Boer RH, Stopeck A, Van Poznak C, Damiao R, Fizazi K, Henry DH, Ibrahim T, Lipton A, Saad F, Shore N, Takano T, Shaywitz AJ, Wang H, Bracco OL, Braun A, Kostenuik PJ (2015) Hypocalcaemia in patients with metastatic bone disease treated with denosumab. Eur J Cancer 51(13):1812–1821CrossRefPubMed
14.
go back to reference Stopeck AT, Fizazi K, Body JJ, Brown JE, Carducci M, Diel I, Fujiwara Y, Martin M, Paterson A, Tonkin K, Shore N, Sieber P, Kueppers F, Karsh L, Yardley D, Wang H, Maniar T, Arellano J, Braun A (2015) Safety of long-term denosumab therapy: results from the open label extension phase of two phase 3 studies in patients with metastatic breast and prostate cancer. Support Care Cancer 24(1):447–455CrossRefPubMedPubMedCentral Stopeck AT, Fizazi K, Body JJ, Brown JE, Carducci M, Diel I, Fujiwara Y, Martin M, Paterson A, Tonkin K, Shore N, Sieber P, Kueppers F, Karsh L, Yardley D, Wang H, Maniar T, Arellano J, Braun A (2015) Safety of long-term denosumab therapy: results from the open label extension phase of two phase 3 studies in patients with metastatic breast and prostate cancer. Support Care Cancer 24(1):447–455CrossRefPubMedPubMedCentral
15.
go back to reference Brufsky AM, Sereika SM, Mathew A, Tomifumi O, Singh V, Rosenzweig M (2013) Long-term treatment with intravenous bisphosphonates in metastatic breast cancer: a retrospective study. Breast J 19(5):504–511PubMed Brufsky AM, Sereika SM, Mathew A, Tomifumi O, Singh V, Rosenzweig M (2013) Long-term treatment with intravenous bisphosphonates in metastatic breast cancer: a retrospective study. Breast J 19(5):504–511PubMed
18.
go back to reference Costa L, Lipton A, Hadji P, Chen YM, Kosmidis P (2013) Treatment of bone metastases before the onset of pain. Int J Clin Oncol 18(3):531–538CrossRefPubMed Costa L, Lipton A, Hadji P, Chen YM, Kosmidis P (2013) Treatment of bone metastases before the onset of pain. Int J Clin Oncol 18(3):531–538CrossRefPubMed
19.
go back to reference Henry DH, Von Moos R, Body JJ, Rider A, De Courcy J, Murray G (2015) Bone targeting agent treatment patterns and the impact of bone metastases on patients with advanced breast cancer in the US. J Clin Oncol 33(Suppl 28S):A93 Henry DH, Von Moos R, Body JJ, Rider A, De Courcy J, Murray G (2015) Bone targeting agent treatment patterns and the impact of bone metastases on patients with advanced breast cancer in the US. J Clin Oncol 33(Suppl 28S):A93
20.
go back to reference Cleeland CS, Body JJ, Stopeck A, von Moos R, Fallowfield L, Mathias SD, Patrick DL, Clemons M, Tonkin K, Masuda N, Lipton A, de Boer R, Salvagni S, Oliveira CT, Qian Y, Jiang Q, Dansey R, Braun A, Chung K (2013) Pain outcomes in patients with advanced breast cancer and bone metastases: results from a randomized, double-blind study of denosumab and zoledronic acid. Cancer 119(4):832–838CrossRefPubMed Cleeland CS, Body JJ, Stopeck A, von Moos R, Fallowfield L, Mathias SD, Patrick DL, Clemons M, Tonkin K, Masuda N, Lipton A, de Boer R, Salvagni S, Oliveira CT, Qian Y, Jiang Q, Dansey R, Braun A, Chung K (2013) Pain outcomes in patients with advanced breast cancer and bone metastases: results from a randomized, double-blind study of denosumab and zoledronic acid. Cancer 119(4):832–838CrossRefPubMed
Metadata
Title
Breast cancer and bone metastases: a call for appropriate treatment
Authors
Diana Lüftner
Daniela Niepel
Publication date
01-10-2016
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 10/2016
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-016-3335-7

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