The Use of Bisphosphonates in Patients With Breast Cancer

Catherine H. Van Poznak, MD


Cancer Control. 2002;9(6) 

In This Article

Potential Use of Bisphosphonates for Prevention of Bone Metastases

Based on the observation that bisphosphonates reduce the release of bone-derived growth factors and cytokines associated with bone resorption, which have the potential to attract cancer cells to bone and facilitate tumor growth and proliferation, it is possible that bisphosphonate therapy may be able to help prevent the development of bone metastases. To explore this concept, clinical trials of adjuvant bisphosphonate therapy have been performed. Two studies have suggested a decrease in the development of osseous metastases and an improvement in survival with the use of adjuvant oral clodronate after primary treatment for operable breast cancer.[43,44] However, Saarto et al[45] reported results to the contrary. To shed light onto these conflicting results, two large, multicenter, randomized clinical trials are investigating the use adjuvant bisphosphonates (NSABP B-34 and SWOG S9905). Until additional data are generated, starting bisphosphonate therapy for the purpose of preventing bone metastases in patients at any stage of nonosseous disease is not recommended outside of a clinical trial.[26]


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