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- Title
Long-term Treatment with Intravenous Bisphosphonates in Metastatic Breast Cancer: A Retrospective Study.
- Authors
Brufsky, Adam M.; Sereika, Susan M.; Mathew, Aju; Tomifumi, Onishi; Singh, Vikramjit; Rosenzweig, Margaret
- Abstract
Bisphosphonates are important therapies used to reduce the risk of skeletal-related events in patients with bone metastases from breast cancer ( BC). This retrospective cohort study evaluated the incidence of osteonecrosis of the jaw ( ONJ) and renal impairment in women ( n = 221) with bone metastases from BC treated with intravenous bisphosphonates from January 1999 to June 2008. In the long-term cohort, 159 patients received pamidronate ( n = 9), zoledronic acid ( n = 110), or both ( n = 40) for ≥24 months. The comparator group consisted of patients treated with intravenous bisphosphonates for 12-23 months ( n = 62). After 39 months' median follow-up, six of 159 patients developed ONJ (3.8%; median 38.5 treatment cycles and 44 months' exposure) in the long-term cohort. Of patients who developed ONJ, 50% resumed intravenous bisphosphonates after a 12-month treatment holiday. Renal impairment developed in 19 patients in the long-term cohort (11.9%; median 26 treatment cycles and 26 months' exposure). Of these 19 patients, 11 (57.9%) recovered baseline renal function and seven (36.7%) showed partial recovery. After modification of the intravenous bisphosphonate regimen, 17 of 19 patients (89.4%) resumed therapy. Of the 62 patients in the comparator cohort, one patient developed ONJ (1.6%) and six developed renal impairment (9.7%). Similar incidence rates of ONJ and renal impairment were observed for the long-term and comparator cohorts. Times to ONJ or renal impairment also were similar across intravenous bisphosphonate type. Long-term (≥24 months) intravenous bisphosphonate use in metastatic BC is well tolerated, with low incidences of ONJ and renal impairment.
- Subjects
PENNSYLVANIA; INTRAVENOUS therapy; OSTEONECROSIS; BREAST tumors; CHI-squared test; CONFIDENCE intervals; DIPHOSPHONATES; FISHER exact test; JAWS; KIDNEY diseases; LONGITUDINAL method; METASTASIS; HEALTH outcome assessment; PROBABILITY theory; RESEARCH funding; STATISTICS; SURVIVAL analysis (Biometry); DATA analysis; RELATIVE medical risk; TREATMENT effectiveness; REPEATED measures design; RETROSPECTIVE studies; DATA analysis software; DESCRIPTIVE statistics; KAPLAN-Meier estimator; EVALUATION
- Publication
Breast Journal, 2013, Vol 19, Issue 5, p504
- ISSN
1075-122X
- Publication type
Article
- DOI
10.1111/tbj.12152