Panel Backs Bone Drugs for Postmenopausal Breast Cancer


“Appropriately selected postmenopausal women with breast cancer warrant consideration for adjuvant bisphosphonate therapy, according to an updated clinical guideline.

“Either zoledronic acid (Zometa) or clodronate may be considered for adjuvant therapy, as data supporting use of other bisphosphonates remain limited. The RANK ligand-targeted monoclonal antibody denosumab (Xgeva) did not make the cut as recommended therapy because of a lack of long-term survival data to support its use.

” ‘Data for adjuvant denosumab look promising but are currently insufficient to make any recommendation,’ concluded a panel of experts representing the American Society of Clinical Oncology (ASCO) and Cancer Care Ontario.”

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De-escalation of Bone-Targeting Agents Appears Safe in Bone Metastases

“A new meta-analysis suggests that de-escalation of bone-targeted agents such as bisphosphonates and denosumab is a safe strategy in patients with bone metastases from breast cancer. There is a growing body of evidence suggesting such de-escalation will soon be considered standard of care.

“Bone-targeted agents are generally given every 3 to 4 weeks beginning at the time of diagnosis of bone metastases, until death. ‘If de-escalation of treatment is as efficacious as 3–4 weekly dosing, it could reduce clinic visits, drug side effects for patients, in addition to reducing costs to both the patient and the health care system,’ wrote study authors led by Mark Clemons, MD, of the Ottawa Hospital Cancer Centre in Canada.

“Clemons and colleagues conducted a systematic review and meta-analysis of published research on de-escalation of bone-targeted agents; six studies reported data for at least one ‘outcome of interest’ involving pamidronate, zoledronate, and denosumab. Results of the analysis were published online ahead of print in Annals of Oncology.

Drugs Home in on Bone Metastases in Prostate Cancer

Bone metastases are common in patients with metastatic castration-resistant prostate cancer (CRPC). They are associated with increased risk of death due to a number of complications such as bone fractures, compression of the spinal cord, and pain. Radiation of the affected bone sites is used as a palliative measure to relieve pain. The U.S. Food and Drug Administration (FDA) has also approved certain drugs for treatment of bone metastases in CRPC including the following: Continue reading…

Zoledronic Acid Did Not Prevent Bone Metastases in High-Risk Prostate Cancer

“The use of zoledronic acid (Zometa) had no effect on the prevention of bone metastases in patients with high-risk prostate cancer, according to the first results of the Zometa European Study, or ZEUS, presented at the European Association of Urology 28th Annual Congress in Milan, Italy…”

Avastin May Be Effective Against Lung Cancer with Bone Metastases

A retrospective study of cancer patients suggests that bevacizumab (Avastin) may be an effective treatment for non-small cell lung cancer (NSCLC) with bone metastases (cancer spread to the bone). The patients had non-squamous NSCLC with bone metastases and had been treated with zoledronic acid (Zometa/Reclast) and chemotherapy either with or without Avastin. Avastin treatment was associated with better control of both bone metastases and overall disease, longer time to bone metastasis progression, and fewer complications related to bone degeneration, such as fractures or spinal cord compression.

Research paper: