The Use of Bisphosphonates in Patients With Breast Cancer

Catherine H. Van Poznak, MD


Cancer Control. 2002;9(6) 

In This Article


Both metastatic breast cancer and bone are involved in cell signaling, and this "vicious cycle" can lead to progression of disease in bone. Bisphosphonates are able to inhibit osteoclast activity and alter the signaling between tumor and bone. Bisphosphonates are the treatment of choice in hypercalcemia of malignancy and provide proven clinical benefit in reducing the skeletal complications of breast cancer and reducing bone pain. For many patients with osseous lesions from breast cancer, bisphosphonate therapy is an important component in the management of their dis-ease. Attention is now being focused on how to optimize the use of bisphosphonates and the identification of patient and tumor-specific characteristics to predict response to therapy. Clinical trials are needed to answer questions such as when is the optimal time to initiate or stop therapy, how best to monitor treatment, and how to use bisphosphonates in a cost-effective manner. New drugs, including small molecules and monoclonal antibodies, are under clinical investigation and may eventually become treatment options, either in conjunction with or as an alternative to bisphosphonate therapy. State-of-the-art care requires that the therapies be as targeted as the present technology will allow. With bone metastases from breast cancer, there are two targets to approach, the tumor and the bone.

The print version of this article was originally certified for CME credit. For accreditation details, contact: H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Drive, Tampa, FL 33612. Telephone: (813) 632-1349. Fax: (813) 903-4950. Email: URL:


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