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New treatment strategy for bone metastases from breast cancer

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Abstract

Breast cancer patients frequently develop bone metastasis. Parathyroid hormone-related protein, an osteoclast activating factor, might be necessary for tumor to erode bone and grow at skeletal site. Bisphosphonates have an affinity for bone and are potent inhibitors of osteoclastic bone resorption. In light of this, 53 patients with bone metastasis from breast cancer were treated with chemoendocrine (mainly high-dose medroxyprogesterone acetate as the endocrine therapy) therapy+bisphosphonate (pamidronate, Aredia®).

During the previous 6 years (median 27 months), 53 breast cancer patients with bone metastasis were treated with pamidronate+chemoendocrine therapy. The regimen consisting of pamidronate+ chemoendocrine agent was administered to 27 patients as a post relapse first-line regimen and to the remaining 26 cases, which failed first-or second-line treatment as a second or third line regimen. As a result of the combination therapy, sclerotic changes were observed in the osteolytic lesions in 31 of the 53 patients (59%). The effect on the osteolytic lesions did not correlate with the duration of disease free interval, estrogen receptor (ER) status, presence/absence of previous therapy or number of “hot spot(s)” on bone scintigraphy.

Lessening of pain from the bone metastasis was achieved in 83% of the patients after 3 months of pamidronate administration.

Pamidronate+chemoendocrine therapy seems highly promising.

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Abbreviations

PTHrP:

Parathyroid hormone-related protein

DFI:

Disease free interval

ER:

Estrogen receptor

MPA:

Medroxyprogesterone acetate

CMF:

Cyclophosphamide, methotrexate, 5-fluorouracil

CAF:

Cyclophosphamide, Doxorubicin, 5-fluorouracil

TAM:

Tamoxifen

UFT:

Tegaful-uracil

TAX:

docetaxel

QOL:

Quality of life

CR:

Complete response

PR:

Partial response

NC:

No change

PD:

Progressive disease

IUCC:

The International Union Against Cancer

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Authors and Affiliations

  1. Department of Surgery, Hyogo Medical Center for Adults, Akashi

    Norio Kohno, Muneharu Konishi & Katunori Kawaguti

  2. 2nd Department Pathology, Kobe University School of Medicine, Akashi

    Sohei Kitazawa

  3. Department of Surgery, Yodogawa Christians Hospital, Akashi

    Kazuyuki Wakita

  4. 1st Department Surgery, Kobe University School of Medicine, Akashi

    Yoshihiko Furuya

Authors
  1. Norio Kohno
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  2. Sohei Kitazawa
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  3. Muneharu Konishi
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  4. Kazuyuki Wakita
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  5. Yoshihiko Furuya
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  6. Katunori Kawaguti
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Kohno, N., Kitazawa, S., Konishi, M. et al. New treatment strategy for bone metastases from breast cancer. Breast Cancer 6, 292–297 (1999). https://doi.org/10.1007/BF02966442

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