A cross-sectional survey of the diagnosis and management of bone metastasis in breast cancer patients in Turkey

Arıcan, Ali; Bozkurt, Tulin; Bozcuk, Hakan; Demirkan, Binnaz; Büyükberber, Süleyman; Alkış, Necati; Şanlı, Ulus Ali; Camcı, Celalettin; Yıldız, Mustafa; Yücel, İdris; Uygun, Kazım; Aslay, I.; Demiray, Mutlu; Beşe, Nuran; Işıkdoğan, Abdurrahman; Bahat, Zümrüt; Gemici, Cengiz; Özdemir, Feyyaz; Özdener, Fatih; Pekin, Bahadir

doi:10.1007/s00520-014-2253-9

Cited by 7 publications

(12 citation statements)

References 20 publications

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“…In total, 89% of the patients with bone metastases received BTA therapy in this study. This number is in line with the three population-based surveys available so far: Kuchuk et [19]. While pamidronate prevailed in these studies, zoledronic acid was the main bisphosphonate used in our cohort from 2007 to 2014 (37%).…”

Section: Start Of Therapy Duration Initial Therapy* End Of Therapysupporting

confidence: 88%

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Treatment and pattern of bone metastases in 1094 patients with advanced breast cancer – Results from the prospective German Tumour Registry Breast Cancer cohort study

Schröder¹,

Fietz²,

Köhler

et al. 2017

European Journal of Cancer

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A high proportion of patients with breast cancer develop bone metastases, yet data on routine treatment with bone-targeted agents (BTA) are rare. We report real-life outcome data of patients with breast cancer metastasised to the bone treated by office-based oncologists in Germany.The ongoing, prospective, multicentre, population-based cohort study Tumour Registry Breast Cancer (TMK) was started in 2007 in 140 centres across Germany. This interim analysis of 1094 patients with bone metastases revealed differences among the tumour subtypes: at start of first-line therapy, 36% of the patients with hormone receptor (HR)-positive and only 20% of the patients with HR-negative tumours presented with bone-only metastasis. The majority of patients with bone metastases (89%, n Z 976) received BTA therapy. In 2014e2015, 37% of the patients received the bisphosphonate zoledronic acid and 36% the antibody denosumab. Median duration of BTA therapy was 20 months (interquartile range 31.5 months), starting a median of 3 weeks after diagnosis of bone metastases, and ending a median of 7 weeks before death. The median overall survival (OS) also varied among the types of metastasis at start of first-line therapy ranging from 54 months (95% confidence interval [CI] 37.6e70.8), 38 months (95% CI 29.4e44.2) to 28 months (95% CI 24.2 e31.0) for patients with bone-only metastases, non-visceral with or without bone metastases and visceral with or without bone metastases respectively.We show that choice and duration of BTA therapies are in conformity with guidelines applicable in Germany. To our knowledge, this is the first presentation of data on incidence, metastatic pattern, treatment and survival of patients with bone metastases in routine practice.

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Section: Start Of Therapy Duration Initial Therapy* End Of Therapysupporting

confidence: 88%

“…However, the demographic and medical characteristics of the general population often differ from patients enrolled in clinical trials. There are only few data on the use of BTAs in routine care, and existing data are often limited by retrospective collection [6,19,20].…”

Section: Introductionmentioning

confidence: 99%

Treatment and pattern of bone metastases in 1094 patients with advanced breast cancer – Results from the prospective German Tumour Registry Breast Cancer cohort study

Schröder¹,

Fietz²,

Köhler

et al. 2017

European Journal of Cancer

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“…Of the remaining 33 records, nine were removed applying the exclusion criteria. The final set of bibliographic records reviewed was composed of 24 studies [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] ( Fig. 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…The results of the quality assessment according to the NOS are shown in supplemental file ( Appendix E ). In total, 24 studies were included and all of which were assessed as high quality: One study [24] was rated with a NOS score of six, eight studies [23] , [26] , [28] , [33] , [36] , [37] , [41] , [42] with a NOS score of seven, six studies [21] , [22] , [32] , [34] , [39] , [40] with a NOS score of eight, seven studies [20] , [25] , [27] , [31] , [35] , [38] , [43] with a NOS score of nine, and two studies [29] , [30] with a NOS score of ten.…”

Section: Resultsmentioning

confidence: 99%

Incidence, risk factors and prognostic characteristics of bone metastases and skeletal-related events (SREs) in breast cancer patients: A systematic review of the real world data

Zhang

Zhu

Biskup

et al. 2018

Journal of Bone Oncology

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PurposeThe aim was to systematically extrapolate the occurrence, risk factors, prognostic characteristics, management and outcome of bone metastases (BM) and skeletal related events (SREs) of breast cancer survivors in the real world clinical setting.MethodsA systematic literature search of PubMed, Web of Science, EMBASE OvidSP and EBSCO Academic Search Complete was conducted. Published prospective and retrospective papers investigating BM and SREs in breast cancer patients in non-trial settings were identified and systematically reviewed.ResultsTwenty-four studies met the inclusion criteria. Incidences of BM based on new diagnosis, length of BM-free interval (BMFI) and number and sites of BM were detected by 17 of 24 studies. Seven studies included in the review were subjected to analyses of risk factors for BM. Developments of SREs regarding the occurrence ratio of total and specific SREs, SERs-free interval (SREFI) and the first-line therapy for SREs were observed in 16 of 24 studies. Out of 5 studies, we extracted uni- and multivariate analysis of risk factor for SREs and out of 16 studies - predictors for survival in breast cancer patients with BM.ConclusionsBM and SREs are common problems in non-trial breast cancer populations. Patient demographics, clinical stage, tumor pathological type, molecular receptors status are significantly risk factors for incidence of BM, SREs and the survival. The unique characteristics of BM and SREs in breast cancer patients should be taken into account in future randomized controlled trials, as to optimize individual treatment options and assure a maximally long good quality of life.

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“…2 Because bone complications are associated with loss of mobility and social functioning, a decrease in quality of life, and a substantial increase in medical costs, [5][6][7][8][9] the management of these patients is complex and requires a multidisciplinary approach. 10 In recent years, bone-targeted agents (BTAs) have become a valuable addition to available options for managing bone metastases, 11 which previously included radiotherapy, use of opioids and other systemic therapies. In Turkey, bisphosphonates such as zoledronic acid and the targeted agent denosumab (a RANK ligand inhibitor) are approved for the prevention of SREs among patients with metastatic bone disease from solid tumors.…”

Section: Introductionmentioning

confidence: 99%

Patients’ and Physicians’ Preferences for Approaches to Bone Metastases Treatment in Turkey

Gatta¹

2015

UHOD

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Bone metastases and associated skeletal-related events (SREs) are common in patients with advanced breast, lung, and prostate cancer. Bone-targeted agents (BTAs) are available for the treatment of bone metastases, but little is known about patients' and physicians' preferences for the various attributes of these agents. We evaluated preferences for BTAs used to prevent SREs among patients with bone metastases and physicians involved in treating such patients in Turkey. Participants completed an online discretechoice experiment survey of 10 questions, choosing between pairs of hypothetical treatment profiles, defined by five BTA attributes: time to first SRE, time to worsening of pain, annual risk of osteonecrosis of the jaw (ONJ), annual risk of renal impairment, and administration regimen. The analysis included 91 patients and 99 physicians. Both groups rated annual risk of renal impairment, time to worsening of pain, and time to first SRE as the most important BTA attributes. For patients, the preference weights for all levels of these attributes were significantly different, whereas for physicians, preference weights were significantly different for all levels except time to a 2-point increase in "Brief Pain Inventory" score by 6 months or 10 months. Annual risk of ONJ was judged by patients and physicians to be the least important of the BTA attributes. This study adds to the information available on the preferences of patients and physicians for BTAs and provides useful data to aid clinicians in decision-making by understanding the treatment goals that are important to patients in Turkey.Keywords: Bone-targeted agents, Bone metastases, Discrete-choice experiment, Patient preference, Physician preference, Skeletal-related event ÖZET Türkiye'de Kemik Metastazı Tedavisine Yaklaşımda Hasta ve Hekim TercihleriKemik metastazları ve bunlardan kaynaklanan iskeletle ilişkili olaylar (İİO) ilerlemiş meme, akciğer ve prostat kanseri olan hastalarda yaygındır. Kemik metastazlarının tedavisi için kemiği hedef alan ilaçlar (BTA'lar) bulunmakla birlikte, hastaların ve hekimlerin bu ilaçların çeşitli özellikleriyle ilgili tercihlerine ilişkin bilgiler sınırlıdır. Türkiye'de yapılan bu çalışmada, kemik metastazları olan hastalar ile bu tip hastaların tedavisini yürüten hekimlerin SRE'lerin önlenmesine yönelik BTA'larla ilgili tercihleri değerlendirilmiştir. Katılımcılar çevrimiçi yapılan ve 10 soru içeren çoktan seçmeli deney anketini tamamlayarak beş BTA özelliği ile tanımlanan hipotetik tedavi profili çiftleri arasında seçim yapmıştır: ilk SRE'ye kadar geçen süre, ağrının kötüleşmesine kadar geçen süre, yıllık çene osteonekrozu (ONJ) riski, yıllık böbrek yetmezliği riski ve uygulama rejimi. Analize 91 hasta ve 99 hekim dahil edilmiştir. Her iki grup da yıllık böbrek yetmezliği riski, ağrının kötüleşmesine kadar geçen süre ve ilk İİO'ya kadar geçen süreyi en önemli BTA özellikleri olarak değerlendirmiştir.

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A cross-sectional survey of the diagnosis and management of bone metastasis in breast cancer patients in Turkey

Cited by 7 publications

References 20 publications

Treatment and pattern of bone metastases in 1094 patients with advanced breast cancer – Results from the prospective German Tumour Registry Breast Cancer cohort study

Treatment and pattern of bone metastases in 1094 patients with advanced breast cancer – Results from the prospective German Tumour Registry Breast Cancer cohort study

Incidence, risk factors and prognostic characteristics of bone metastases and skeletal-related events (SREs) in breast cancer patients: A systematic review of the real world data

Patients’ and Physicians’ Preferences for Approaches to Bone Metastases Treatment in Turkey

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