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Long-term outcomes of prolonged bisphosphonates more than 2 years in bone metastatic breast cancer: risk vs benefit

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Abstract

Background

Bisphosphonates are the mainstay therapeutic options for prevention of skeletal-related events and generally used for up to 2 years in bone metastatic cancer patients.

Aim

We aimed to evaluate the long-term outcomes of prolonged (> 2 years) bisphosphonate usage in bone metastatic breast cancer (BMBC) patients.

Methods

Ninety-nine BMBC patients who had prolonged bisphosphonates were evaluated retrospectively for long-term outcomes and survival rates.

Results

Median duration of bisphosphonate therapy was 46.8 (24–198) months. Seven patients had bisphosphonate-related adverse events (osteonecrosis of the jaw (ONJ) (n = 6), ONJ and renal failure (n = 1)). Bisphosphonate was switched to another one because of bone metastasis progression in more than one-third of the patients (n = 36, 36.3%). The patients who had bisphosphonate switch therapy had statistically significant longer overall survival (p < 0.01). Neither duration nor type of bisphosphonates had effect on frequency of bisphosphonate-related adverse events.

Conclusion

Bisphosphonates might be prolonged for more than 2 years in BMBC patients with an acceptable toxicity profile. In addition, bisphosphonates switch therapy should be preferred in those with progressive bone metastasis since it might contribute to better survival despite bisphosphonates could not have been shown to have survival benefit in previous studies.

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Authors and Affiliations

  1. Department of Medical Oncology, Ankara Numune Training and Research Hospital, 06200, Ankara, Turkey

    Oznur Bal & Mutlu Dogan

  2. Department of Medical Oncology, Ankara Oncology Training and Research Hospital, Ankara, Turkey

    Berna Oksuzoglu, Ayse Durnali, Ayse Demirci, Ulku Yalcıntas Arslan, Ahmet Siyar Ekinci & Necati Alkis

  3. Department of Medical Oncology, Abant Izzet Baysal University, Bolu, Turkey

    Ummugul Uyeturk

  4. Department of Medical Oncology, Yıldırım Beyazıt University, Ankara, Turkey

    Nuriye Yildirim

  5. Department of Epidemiology, Gülhane Military Medical Academy, Ankara, Turkey

    Selim Kilic

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  1. Oznur Bal
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Correspondence to Mutlu Dogan.

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Bal, O., Oksuzoglu, B., Dogan, M. et al. Long-term outcomes of prolonged bisphosphonates more than 2 years in bone metastatic breast cancer: risk vs benefit. Ir J Med Sci 189, 805–810 (2020). https://doi.org/10.1007/s11845-019-02120-6

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  • DOI: https://doi.org/10.1007/s11845-019-02120-6

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