Adjuvant Bisphosphonates in Breast Cancer

Debu Tripathy, MD, co-leader, Women's Cancer Program, University of Southern California Norris Comprehensive Cancer Center, discusses using adjuvant bisphosphonates as a treatment option for patients with breast cancer.

Clinical Pearls:

• Bisphosphonates inhibit osteoclast and bone turnover and lower the complication rate in patients with bone metastasis in addition to being an effective osteoporosis treatment
• Because of the nature of bisphosphonates, it has been hypothesized that there may be an adjuvant benefit in patients with early-stage breast cancer
• The results of zoledronate have generally been negative, but when looking at the results of studies in postmenopausal patients or studies of patients who are receiving ovarian blockade, there appears to be a benefit
• An overview analysis of bisphosphonate trials showed that there was a clear improvement in outcome, particularly in postmenopausal patients in terms of metastatic disease and bone metastasis
• Since the benefits seen from the bisphosphonate trials in terms of mortality is comparable to the range seen with adjuvant chemotherapy, the professional community needs to deliberate over the data