Georgetown Physician: Osteoporosis Drug Should be Part of Treatment for Postmenopausal Women with Breast Cancer
The Lancet today published a study examining the use of osteoporosis drugs called bisphosphonates in women with breast cancer. Given the findings, Claudine Isaacs, MD, professor of medicine and oncology at Georgetown Lombardi Comprehensive Cancer Center in Washington, DC, says, “…Bisphosphonates are something that we need to be integrating into the treatment of our postmenopausal patients with breast cancer.”
Isaacs is co-director of the breast cancer program at Georgetown Lombardi. Additional comments are below. (Disclosure: Dr. Isaacs receives research support from Novartis.)
“This study is a meta-analysis of a number of large randomized clinical trials that examined the role of bisphosphonates as adjuvant therapy for breast cancer. They include a heterogeneous groups of patients, but a number of them suggested on unplanned analysis that the benefit was only seen in postmenopausal women. So what this study did was to perform a metaanalysis of these trials, and examine the benefits in different subsets – including, importantly, looking at the difference in pre- and postmenopausal women.
“In this analysis there were over 11,000 postmenopausal women and what the study demonstrated is that the use of bisphosphonates, which are general quite well-tolerated medications, for somewhere from 2 to 5 years was associated with a very significant reduction in risk of bone recurrence and, even more impressively, overall survival. The absolute benefit was a little over than 3% for overall survival.
“Again, this benefit was only seen in postmenopausal women and not in premenopausal women. There are some preclinical data that suggest a rationale for this.
“My sense is that this is very important and clinically relevant. These medications are widely available. They are used and approved for the treatment of osteoporosis in postmenopausal women so we know the safety profile and overall, these drugs are well-tolerated. There are some rare side effects seen with them that are concerning. There is about a 1% incidence, particularly in the IV version, of osteonecrosis of the jaw, which is a very painful side effect.
“I think bisphosphonates are something that we need to be integrating into the treatment of our postmenopausal patients with breast cancer.”
To arrange an interview with Claudine Isaacs, please contact Karen Teber at Georgetown University Medical Center at firstname.lastname@example.org or 215-514-9751.