Treatment of breast cancer with bone metastasis: bisphosphonate treatment - current and future.
There are a variety of treatments for patients with bone metastases from breast cancer. These include bisphosphonates, antitumor endocrine and cytotoxic systemic therapies, radiotherapy to the metastatic site, radionucleotides, and conservative treatment (analgesics). The optimal combination treatment for bone metastases is not clear. Bisphosphonates are effective for reducing skeletal complications such as bone pain, pathological fracture, bone surgery, and hypercalcemia. Bisphosphonates are recommended as the gold standard therapy for breast cancer with bone metastases. Treatment guidelines tend to recommend starting a bisphosphonate at the time of diagnosis of bone metastases. Animal models have supported the prevention of bone metastasis by bisphosphonate therapy, but three major adjuvant clinical trials of the oral bisphosphonate clodronate have yielded conflicting results. However, our preliminary trial of an intravenous bisphosphonate, pamidronate, showed effective inhibition of bone metastases. The use of bisphosphonates, especially zoledronic acid, as adjuvant therapy is promising, but it is still investigational.
Kohno
Norio
N
Department of Breast Oncology, Tokyo Medical University, Shinjuku-ku, Tokyo, 160-0023, Japan. nkohno@tokyo-med.ac.jp
D000818:Animals; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D050071:Bone Density Conservation Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000188:drug therapy* / Q000556:secondary*; D001943:Breast Neoplasms / Q000473:pathology*; D004164:Diphosphonates / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007571:Jaw Diseases / Q000139:chemically induced; D010020:Osteonecrosis / Q000139:chemically induced; D000077268:Pamidronate
D000970:Antineoplastic Agents; D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D000077268:Pamidronate