Baseline serum NTx levels are prognostic in metastatic breast cancer patients with bone-only metastasis

Ali, Suhail M.; Demers, Laurence M.; Leitzel, Kim; Harvey, Harold A.; Clemens, Dahn L.; Mallinak, N.; Engle, Linda; Chinchilli, Vernon M.; Costa, Luís; Brady, C.; Seaman, John J.; Lipton, Allan

doi:10.1093/annonc/mdh089

Cited by 62 publications

(38 citation statements)

References 15 publications

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“…Serum C-telopeptide was chosen as the biomarker for the study because blood levels of that marker were found to correlate with survival in patients with bone metastasis 28 . Patients entered the study after receiving a minimum of 3 cycles of monthly pamidronate.…”

Section: 22mentioning

confidence: 99%

Treatment Recommendations for the Use of Bone-Targeted Agents in 2011—Report from the 6th Annual Bone and the Oncologist New Updates Meeting

et al. 2012

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Section: 22mentioning

confidence: 99%

Treatment Recommendations for the Use of Bone-Targeted Agents in 2011—Report from the 6th Annual Bone and the Oncologist New Updates Meeting

et al. 2012

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“…Studies have shown that high levels of NTX correlate with a shorter duration of time to progression, skeletal-related events (SREs) and survival [13,14]. Serial measurements of bone turnover markers can be used as a guide to the frequency and dosage of bisphosphonate drug used.…”

Section: Bone Turnover Markersmentioning

confidence: 99%

“…These patients often have high uNTX levels and if so are most at risk of skeletal complications [13,14]. Further research is required to evaluate whether normalizing NTX levels in these patients improves the risk of skeletal events.…”

Section: Future Directionsmentioning

confidence: 99%

Bisphosphonates and metastasis

Lester

Coleman

2005

Breast Cancer Online

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IntroductionIn recent years the increasing use of adjuvant chemotherapy and endocrine therapy have resulted in a decline in breast cancer mortality despite a steady increase in incidence [1].Bone is a common site for the distant spread of breast cancer with as many as 70% of breast cancer patients having bone metastasis at post-mortem. Significant morbidity from bone metastasis may occur due to pathological fracture, hypercalcaemia of malignancy, pain and spinal cord compression [2].The bisphosphonates are potent inhibitors of osteoclast function. There are two different classes of bisphosphonates; the nitrogen containing and the non-nitrogen containing compounds. Nitrogen containing bisphosphonates include pamidronate, alendronate, risedronate, zoledronic acid and ibandronate. These drugs have the greatest affinity and potency and act through the inhibition of farnesyl diphosphate (FPP) synthase in the mevalonate pathway. Nonnitrogen containing bisphosphonates include etidronate and clodronate, with the latter working through effects on mitochondrial ATP in osteoclasts.The exact mechanisms of action remain unclear. However, animal studies with a variety of tumour models suggest that bisphosphonates may stimulate apoptosis of both the tumour cell and the osteoclast [3][4][5]. Bone turnoverBone is constantly undergoing a process of renewal known as remodelling. This process of bone resorption followed by formation is a delicate balance between two cell types, the osteoclast and the osteoblast. Control of these cell types is regulated by a combination of systemic hormones and local factors that affect the replication and differentiation of osteoblasts and osteoclasts.Growth factors, such as insulin-like growth factors (IGF-I and IGF-II), transforming growth factor-␤ (TGF-␤), fibroblast growth factors (FGFs) and plateletderived growth factor (PDGF) mainly act to increase bone formation and repair. Cytokines involved in Abstract Bone metastases frequently occur in advanced breast cancer patients and once incorporated into bone have profound effects on bone physiology. Bisphosphonates are potent inhibitors of osteoclastic function and are becoming increasingly important for the management of patients with breast cancer. They affect the ability of cancer cells to accelerate bone turnover and as a result control pain and reduce the risk of pathological fracture.Furthermore ongoing clinical trials are investigating the role of bisphosphonates as an adjuvant therapy in high-risk breast cancer patients with an aim to prevent bone metastasis.This article reviews the mechanisms of bone metastasis and will discuss present and future developments for the monitoring and treatment of metastatic bone disease.

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“…In addition, more appropriate use of the bisphosphonates in a more individualized treatment approach could reduce direct drug costs, toxicity (for example, rates, the less-intensive treatment regimen was equivalent to the standard regimen in the overall population of metastatic breast cancer patients. Notably, the study did not use any biomarkers of bone turnover to define sre risk, and so from a practical standpoint, its findings are highly important 4 .…”

mentioning

confidence: 99%

Time to Put an End to the “One Size Fits All” Approach to Bisphosphonate Use in Patients with Metastatic Breast Cancer?

2012

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Baseline serum NTx levels are prognostic in metastatic breast cancer patients with bone-only metastasis

Abstract: In this study, breast cancer patients with bone-only or bone plus soft tissue metastasis and elevated serum NTx levels have a shorter duration of clinical benefit, TTP and overall survival.

Cited by 62 publications

References 15 publications

Treatment Recommendations for the Use of Bone-Targeted Agents in 2011—Report from the 6th Annual Bone and the Oncologist New Updates Meeting

Treatment Recommendations for the Use of Bone-Targeted Agents in 2011—Report from the 6th Annual Bone and the Oncologist New Updates Meeting

Bisphosphonates and metastasis

Time to Put an End to the “One Size Fits All” Approach to Bisphosphonate Use in Patients with Metastatic Breast Cancer?

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