Quantitative ultrasound and DXA measurements in aromatase inhibitor-treated breast cancer women receiving denosumab.
OBJECTIVE
Denosumab has been proven to reduce fracture risk in breast cancer (BC) women under aromatase inhibitors (AIs). Quantitative ultrasound (QUS) provides information on the structure and elastic properties of bone. Our aim was to assess bone health by phalangeal QUS and by dual-energy X-ray absorptiometry (DXA), and to evaluate bone turnover in AIs-treated BC women receiving denosumab.


METHODS
35 Postmenopausal BC women on AIs were recruited (mean age 61.2 ± 4.5 years) and treated with denosumab 60 mg administered subcutaneously every 6 months. Phalangeal QUS parameters [Amplitude Dependent Speed of Sound (AD-SoS), Ultrasound Bone Profile Index (UBPI), Bone Transmission Time (BTT)] and DXA at lumbar spine and femoral neck were performed. Serum C-telopeptide of type 1 collagen (CTX) and bone-specific alkaline phosphatase (BSAP) were also measured. The main outcomes were compared with a control group not receiving denosumab (n = 39).


RESULTS
In patients treated with denosumab, differently from controls, QUS and DXA measurements improved after 24 months, and a reduction of CTX and BSAP was detected at 12 and 24 months in comparison to baseline (P < 0.05). The percent changes (Δ) of QUS measurements were significantly associated with ΔBMD at femoral neck, and ΔCTX and ΔBSAP were associated with ΔBMD at lumbar spine (r = -0.39, P = 0.02; r = -0.49, P = 0.01, respectively).


CONCLUSIONS
Denosumab preserves bone health as assessed by phalangeal QUS and DXA. Since inexpensive and radiation-free, phalangeal QUS may be considered in the follow-up of AIs-treated BC women receiving denosumab.
Department of Clinical and Experimental Medicine, University Hospital of Messina, University Hospital "G. Martino", Via C. Valeria, 98125, Messina, Italy. catalanoa@unime.it.
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Catalano
Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
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Gaudio
Department of Clinical and Experimental Medicine, University Hospital of Messina, University Hospital "G. Martino", Via C. Valeria, 98125, Messina, Italy.
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Morabito
Department of Clinical and Experimental Medicine, University Hospital of Messina, University Hospital "G. Martino", Via C. Valeria, 98125, Messina, Italy.
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Basile
Department of Human Pathology, University of Messina, Messina, Italy.
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Agostino
Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
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Xourafa
Department of Clinical and Experimental Medicine, University Hospital of Messina, University Hospital "G. Martino", Via C. Valeria, 98125, Messina, Italy.
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Atteritano
Department of Clinical and Experimental Medicine, University Hospital of Messina, University Hospital "G. Martino", Via C. Valeria, 98125, Messina, Italy.
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Morini
Mineral Metabolism and Nephrology Clinic of Vibo Valentia Hospital, Vibo Valentia, Italy.
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Natale
Department of Clinical and Experimental Medicine, University Hospital of Messina, University Hospital "G. Martino", Via C. Valeria, 98125, Messina, Italy.
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Lasco
D015502:Absorptiometry, Photon / Q000379:methods*; D047072:Aromatase Inhibitors / Q000009:adverse effects*; D015519:Bone Density / Q000187:drug effects*; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D016723:Bone Remodeling / Q000187:drug effects; D001943:Breast Neoplasms / Q000188:drug therapy*; D000069448:Denosumab / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000139:chemically induced / Q000000981:diagnostic imaging* / Q000473:pathology; D017698:Postmenopause; D011446:Prospective Studies; D014463:Ultrasonography / Q000379:methods*
D047072:Aromatase Inhibitors; D050071:Bone Density Conservation Agents; D000069448:Denosumab
Aromatase inhibitors; Bone mineral density; Bone turnover; Breast cancer; Denosumab; Quantitative ultrasound