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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

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