Thursday, December 12, 2013

SABCS: Are Common Bone Drugs the TNBC Follow-Up Treatment We’ve Been Seeking?

They reduce the risk of bone metastases following breast cancer in post-menopausal women by 34 percent. And they reduce the risk of death in that same group by 17 percent, regardless of receptor status, node involvement or previous chemotherapy.  

They’re common bisphosphonates, drugs used to build our bones, such as Zometa and Reclast.

This could be a game changer, says Rob Coleman, M.D., who presented the findings at the 2013 San Antonio Breast Cancer Symposium today.  “We finally have defined an addition to standard treatment.”  
Coleman, of the Sheffield Cancer Research Center in England, says he is likely to recommend bisphosphonates to his postmenopausal patients.  They present “at least as large a benefit as the agents we use presently,” he says.

For triple-negative breast cancer patients, bisphosphonates may represent an elusive follow-up drug.  Because TNBC tumors are not fueled by hormones they do not respond to common post-cancer estrogen-fighting drugs  such as tamoxifen or Arimidex.

The results, part of of the Early Breast Cancer Trialists' Collaborative Group (EBCTCG)'s Bisphosphonate Working Group, represent data from multiple studies on nearly 18,000 patients. They hold true for two broad types of bisphosphonates: zoledronic acid (Zometa, Zomera, Aclasta and Reclast) or clodronates (Bonefos, Clasteon, Loron).

The results apply only to postmenopausal patients—natural or chemotherapy-induced. Premenopausal women did not see any cancer-fighting benefit from bisphosphonates.

It’s essential that bisphosphonates be given early in treatment, Coleman said.

Read more about TNBC in my book, Surviving Triple-Negative Breast Cancer.

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[S4-07] Effects of bisphosphonate treatment on recurrence and cause-specific mortality in women with early breast cancer: A meta-analysis of individual patient data from randomized trials. 

Coleman R, Gnant M, Paterson A, Powles T, von Minckwitz G, Pritchard K, Bergh J, Bliss J, Gralow J, Anderson S, Evans V, Pan H, Bradley R, Davies C, Gray R, On Behalf of the Early Breast Cancer Trialists' Collaborative Group (EBCTCG)'s Bisphosphonate Working Group. Sheffield Cancer Research Centre


Anonymous said...

Pat, thank you so much for this blog and your book. They provide exactly what TNBC patients and survivors need to know.

Theresa said...

Thank you for posting this article about bisphosphonates. One question I have is whether these drugs are a follow up to treatment or part of treatment. If a follow up, what time frame are we talking about.

I'm a little confused about the word "early" in your sentence:
"It’s essential that bisphosphonates be given early in treatment, Coleman said."

I checked out the link to the research and didn't find that. Can you clarify this or point me to a direction that might help?

Patricia Prijatel said...

Theresa: Coleman said that in person, at the conference, so it was not in the paper. By early, he meant when you start treatment. Seems like you would get some benefit no matter when you start, though.

Theresa H. said...

Thanks for the additional information. As someone who has been treated for TNBC, I am always looking for new ways to stay healthy. I plan to check this out with my oncologist next month at my checkup visit. I'll be happy to share any info I learn.

Unknown said...

ok, so im tnbc stage 2a, no node involvement, my oncologist wants to put me on zometa, but my question is this, the chemo pushed me into menopause, (im only 43, so its chemo induced), also, im brca1+ they've put me on tomoxifen (because my right breast was positive and my left breast was tnbc), I have to have a hesterectomy (complete) because of the tamoxifen and because of the brca1+ . my oncologist says this will help me with my possibility of recurrence, but as I read it states that if im already in menopause the drug doesn't and will not work for me.
thank you joanetta

Anonymous said...

if im reading the article correctly zometa doesn't work on menopausal women. my oncologist is wanting me to start this in march, (first wants me to get a dental clearance) I was diagnosed with tnbc stage 2a no node involvement on my left breast and quad positive stage 1a on my right breast (er, pr, her2 and her3 positive). I was on carboplatin, taxotere and Herceptin. Im continuing Herceptin till nov 2014. im in menopause at this point, also I tested positive for the brca1+ mutation, so I have to get my ovaries removed, im also on tamoxifen so at the same time im getting my uterus and cervix removed because the drug causes cancer. so my question is this, will zomata actually work for me?

Patricia Prijatel said...

Zometa is actually a drug for menopausal women. The post-menopause just means after menopause starts. It seems to me that you would benefit, so I would trust the doc on this one.