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- Title
N-Telopeptide of Type I Collagen Long-Term Dynamics in Breast Cancer Patients With Bone Metastases: Clinical Outcomes and Influence of Extraskeletal Metastases.
- Authors
Ferreira, Arlindo R.; Alho, Irina; Shan, Ning; Matias, Margarida; Faria, Mariana; Casimiro, Sandra; Leitzel, Kim; Ali, Suhail; Lipton, Allan; Costa, Luís
- Abstract
Background. Markers of bone metabolism, such as N-telopeptide of type I collagen (NTX), have been demonstrated to be prognostic in previous trials of breast cancer (BC) patients with bone metastases (BMs). In the present study, we tested the survival effect of the NTX response to zoledronic acid (ZA) at 3 and 12 months in a contemporaneous cohort of BC patients with BMs and evaluated the influence of extraskeletal meta-static disease on NTX variation. Patients and Methods. The present study was a prospective cohort study of consecutive BC patients diagnosed and treated at a single center. Patients presenting with de novo radiological evidence of BMs who started monthly intravenous ZA were included. Urinary NTX was measured at baseline and 1, 3, 6,9, and 12 months after ZA introduction. Results. Overall, 71 patients were enrolled, 32 with BMs and 39 with BMs plus extraskeletal metastases. The proportion of patients with elevated NTX at baseline and 3 and 12 months was 49.3%, 26.6%, and 34.2%, respectively. The variables associated with survival included age at diagnosis, tumor estrogen receptor status, and NTX at 3 and 12 months. Multivariate analysis showed that, in addition to age at diagnosis, only the 3-month NTX level was significantly associated with survival. Patients with BMs plus extraskeletal metastases had an erratic NTX variation pattern, unrelated to survival. Conclusion. In the present contemporaneous cohort of BC patients with BMs, the NTX response at 3 months was strongly associated with survival. Furthermore, an early response to ZA was strongly associated with long-term NTX control. Finally, patients with BMs plus extraskeletal metas-tases had an erratic NTX variation.
- Subjects
ZOLEDRONIC acid; AGE factors in disease; BIOMARKERS; BONE metastasis; BREAST tumors; CHI-squared test; COLLAGEN; COMPARATIVE studies; CONFIDENCE intervals; ENZYME-linked immunosorbent assay; LONGITUDINAL method; MULTIVARIATE analysis; PROBABILITY theory; RESEARCH funding; STATISTICS; SURVIVAL analysis (Biometry); T-test (Statistics); MATHEMATICAL variables; LOGISTIC regression analysis; SAMPLE size (Statistics); PROPORTIONAL hazards models; DATA analysis software; DESCRIPTIVE statistics; KAPLAN-Meier estimator; METABOLISM; THERAPEUTICS
- Publication
Oncologist, 2016, Vol 21, Issue 12, p1418
- ISSN
1083-7159
- Publication type
Article
- DOI
10.1634/theoncologist.2015-0527