Denosumab vs. zoledronic acid treatment in post-menopausal breast cancer: a 2-year prospective observational study.

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  • Additional Information
    • Source:
      Publisher: Informa Healthcare Country of Publication: England NLM ID: 0404375 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1502-7686 (Electronic) Linking ISSN: 00365513 NLM ISO Abbreviation: Scand J Clin Lab Invest Subsets: MEDLINE
    • Publication Information:
      Publication: London : Informa Healthcare
      Original Publication: Oslo, Medisinsk Fysiologisk Forenings Forlag.
    • Subject Terms:
      Breast Neoplasms/*drug therapy ; Denosumab/*therapeutic use ; Postmenopause/*physiology ; Zoledronic Acid/*therapeutic use; Aged ; Biomarkers/metabolism ; Bone Density/drug effects ; Bone Remodeling/drug effects ; Breast Neoplasms/physiopathology ; Calcium/metabolism ; Denosumab/pharmacology ; Female ; Homeostasis/drug effects ; Humans ; Middle Aged ; Prospective Studies ; Zoledronic Acid/pharmacology
    • Abstract:
      Adjuvant treatment for post-menopausal women with early breast cancer (BC) includes aromatase inhibitors (AI), known to decrease bone mineral density (BMD). In this study, we investigate whether denosumab is a valid second option for patients unable to receive standard adjuvant i.v. zoledronic acid (ZA). In total, 212 patients have been evaluated after they did not receive ZA. Of those 194 were included. After evaluation by an endocrinologist, all patients were offered ZA as their first choice and 15% accepted ( N  = 29). The remaining 85% were offered denosumab ( N  = 165). All patients were followed prospectively with blood tests up to 24 months. DXA scans were performed at baseline and 24 months. No difference was observed between the two treatment groups at baseline, with regard to anthropometry and standard biochemistry. Markers of bone turnover (p-PINP, p-CTX, p-bone-specific alkaline phosphatase and p-osteocalcin) all showed significant suppression compared to baseline and remained suppressed throughout the 2 years. BMD showed small and significant increases at the spine (0.024 g/cm 2 ) and total hip (0.019 g/cm 2 ) in the denosumab group but no change at the femoral neck(-0.011g/cm 2 ). In the ZA group, we observed no significant change at the spine (0.015 g/cm 2 ) and total hip (-0.001g/cm 2 ) and a small significant decrease at the femoral neck (-0.037 g/cm 2 ). However, when we compared BMD change between the treatment groups, we found no significant difference. Conclusions: Our data indicate that for BC patients in AI treatment who refused or were not able to receive ZA treatment, denosumab might be recommended as a second choice. Regarding markers of bone turnover and BMD denosumab is equal to ZA. Summary: Women with early breast cancer receiving anti-estrogen treatment are at risk of developing osteoporosis.We followed 194 women receiving zoledronic acid (ZA) or denosumab for up to 2 years.We find that with regard to bone protection, denosumab is a viable alternative to ZA and might be recommended as a second choice.
    • Contributed Indexing:
      Keywords: Breast cancer; bone; bone remodeling; denosumab; zoledronic acid
    • Accession Number:
      0 (Biomarkers)
      4EQZ6YO2HI (Denosumab)
      6XC1PAD3KF (Zoledronic Acid)
      SY7Q814VUP (Calcium)
    • Publication Date:
      Date Created: 20210614 Date Completed: 20220303 Latest Revision: 20220303
    • Publication Date:
      20231215
    • Accession Number:
      10.1080/00365513.2021.1929447
    • Accession Number:
      34120544