Changes of bone turnover markers and serum PTH after night or morning administration of zoledronic acid in breast cancer patients with bone metastases

Purpose This study evaluated whether additional palliative benefits could be derived from the second-line use of the more potent bisphosphonate zoledronic acid in metastatic breast cancer patients with either progressive bone metastases or skeletal-related events (SRE), despite first-line therapy with either pamidronate or clodronate. Patients and Methods This prospective study evaluated the impact of second-line zoledronic acid on pain, quality of life, and markers of bone turnover (for example, urinary N-telopeptide [NTX]). Patients received monthly zoledronic acid (4mg) for 3 months. Study evaluations were made weekly during the first month and again at week 8. No changes in chemotherapy or endocrine therapy were allowed in the month before or after commencing study treatment. Results Thirty-one women completed this study. By week 8, patients had experienced significant improvements in pain control (P < .001). There was a downward trend in urinary NTX levels over the same time period (P = .008). Overall, there was a trend towards a positive correlation between improvement in pain control and reduction in week one urinary NTX relative to baseline (Spearman's rho r = 0.27; P = .15). Conclusion This is the first study to demonstrate that patients with either progressive bone metastases or SREs while on clodronate or pamidronate can have relevant palliative benefits with a switch to the more potent bisphosphonate zoledronic acid. This is reflected by significant improvements in pain control and bone turnover markers. If confirmed in randomized trials, these findings have major implications to the use of bisphosphonates in both the metastatic and adjuvant settings.

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Evaluation of Pentosidine as Bone Quality Marker in Postmenopausal Breast Cancer Patients Receiving Aromatase Inhibitors

10.21203/rs.3.rs-42565/v1 ◽

2020 ◽

Author(s):

Hideo Shigematsu ◽

Tomoyuki Yoshiyama ◽

Daisuke Yasui ◽

Shinji Ozaki

Keyword(s):

Breast Cancer ◽

Bone Turnover ◽

Cancer Patients ◽

Bone Quality ◽

Bone Turnover Markers ◽

Postmenopausal Breast Cancer ◽

Breast Cancer Patients ◽

Significant Difference ◽

Average Change ◽

Turnover Markers

Abstract Background: Osteoporosis and fractures are important aromatase inhibitor (AI) related adverse events in postmenopausal women with hormone receptor positive breast cancer. An increment of pentosidine is associated with a deterioration of bone quality. In this study, pentosidine was evaluated in postmenopausal breast cancer patients receiving AIs. Methods: Fifty postmenopausal breast cancer patients receiving AIs were retrospectively evaluated. Sixteen patients were given a bone modifying agent (BMA) concomitant with AIs. Changes of pentosidine, bone turnover markers and bone mineral density (BMD) before and after 12 months of AI therapy were compared between BMA administered patients (BMA group) and a non-BMA group.Results: There was no significant difference between pentosidine low and high groups in regard to age, height, weight, BMD of femoral neck and lumbar spine, and bone turnover markers including TRACP-5b and BAP. In the non-BMA group, pentosidine was increased in 18 cases (53%), and the average change of pentosidine was 21.5% (95%CI; 0.23 to 42.7%, p=0.048). In the BMA group, pentosidine was increased in 2 two cases (13%), and the average change of pentosidine was -16.6% (95%CI; -30.6 to -2.6%, p=0.023). There was a significantly lower proportion of pentosidine-increased cases (p=0.0065) and decrease of pentosidine (p=0.021) in the BMA group compared to those in the non-BMA group. Conclusions: Pentosidine was an independent factor from risk factors of osteoporotic fracture. Pentosidine was increased with AI, however, BMA inhibits an AI-induced increase of pentosidine in postmenopausal breast cancer patients.

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Evaluation of Pentosidine as Bone Quality Marker in Postmenopausal Breast Cancer Patients Receiving Aromatase Inhibitors

10.21203/rs.3.rs-42565/v2 ◽

2020 ◽

Author(s):

Hideo Shigematsu ◽

Tomoyuki Yoshiyama ◽

Daisuke Yasui ◽

Shinji Ozaki

Keyword(s):

Breast Cancer ◽

Bone Turnover ◽

Cancer Patients ◽

Bone Quality ◽

Bone Turnover Markers ◽

Postmenopausal Breast Cancer ◽

Categorical Variables ◽

Breast Cancer Patients ◽

Average Change ◽

Turnover Markers

Abstract Background: Osteoporosis and fractures are important aromatase inhibitor (AI) related adverse events in postmenopausal women with hormone receptor positive breast cancer. An incremental increase of pentosidine is associated with a deterioration of bone quality. In this study, pentosidine was evaluated in postmenopausal breast cancer patients receiving AIs.Methods: Fifty Japanese postmenopausal breast cancer patients receiving AIs were retrospectively evaluated. Sixteen patients were given a bone modifying agent (BMA) concomitant with AIs. Changes of pentosidine, bone turnover markers and bone mineral density (BMD) before and after 12 months of AI therapy were compared between BMA administered patients (BMA group) and a non-BMA group. These factors were assessed by BMA groups using chi-square of categorical variables and t-test for continuous variables.Results: The median age of the subjects was 67 years, and 21, 23 and 6 subjects were classified as normal, bone loss and osteoporosis, respectively. There was no significant difference between pentosidine low and high groups in regard to age, height, weight, BMD of femoral neck and lumbar spine, and bone turnover markers including TRACP-5b and BAP. In the non-BMA group, pentosidine was increased in 18 cases (53%), and the average change of pentosidine was 21.5% (95%CI; 0.23 to 42.7%, p=0.048). In the BMA group, pentosidine was increased only in 2 cases (13%), and the average change of pentosidine was -16.6% (95%CI; -30.6 to -2.6%, p=0.023). There was a significantly lower proportion of pentosidine-increased cases (p=0.0065) and decrease of pentosidine (p=0.021) in the BMA group compared to those in the non-BMA group.Conclusions: Pentosidine was increased with AI, however, BMA inhibits an AI-induced increase of pentosidine in postmenopausal breast cancer patients.

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