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Bisphosphonates as adjuvant therapy for breast cancer

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Abstract

Breast cancer is the most common malignancy among women worldwide. Emerging results from clinical trials in patients with breast cancer suggest that, in addition to preventing cancer treatment-induced bone loss, bisphosphonates may improve disease-free survival (DFS). Although the first adjuvant studies using the early generation oral bisphosphonate clodronate suggested potential reductions in distant recurrence versus placebo in patients with early breast cancer, subsequent results with clodronate were inconsistent, and oral pamidronate produced no disease recurrence benefits versus chemotherapy alone in this setting. In contrast, addition of the newer bisphosphonate zoledronic acid to adjuvant therapy reduced disease recurrence rates and improved DFS compared with adjuvant endocrine therapy alone in two phase 3 studies in postmenopausal women with early breast cancer. Adjuvant zoledronic acid also significantly improved DFS compared with endocrine therapy alone in premenopausal women with breast cancer. Data from ongoing and future trials will further define the role of bisphosphonates in the adjuvant breast cancer setting.

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  1. Department of Surgery, Medical University of Vienna, Währinger Gürtel 18-20, A-1090, Vienna, Austria

    Michael Gnant

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  1. Michael Gnant
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  2. Peter Dubsky
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  3. Florian Fitzal
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  4. Thomas Bachleitner-Hofmann
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Correspondence to Michael Gnant.

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Gnant, M., Dubsky, P., Fitzal, F. et al. Bisphosphonates as adjuvant therapy for breast cancer. Curr Breast Cancer Rep 1, 54–63 (2009). https://doi.org/10.1007/s12609-009-0008-2

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