Prevention and treatment of osteoporosis in postmenopausal women with estrogen receptor-positive breast cancer receiving aromatase inhibitors


Authors: Michalská Dana
Authors‘ workplace: III. interní klinika 1. LF UK a VFN v Praze
Published in: Clinical Osteology 2018; 23(3): 112-119
Category:

Overview

Aromatase inhibitors (AIs) are the preferred therapy for postmenopausal women with estrogen receptor-positive breast cancers. However, their long-term use causes bone loss and increased risks of osteoporosis and fractures. With increased breast cancer survival, recognition of survivorship care issues, including bone health, has become more compelling than ever before. The recommendations for the prevention of osteoporosis and fracture include lifestyle recommendations, calcium and vitamin D supplementation. Bisphosphonates (BP) have been shown in several phase III trials to prevent the bone loss induced by cancer treatment, although no fracture date are available. BP treatment is covered by public insurance policy only for patients diagnosed with osteoporosis or prevalent osteoporotic fracture. Given the long-term nature of AI treatment with rapidly diminishing BMD, which can lead all the way to serious fractures, select current recommendations guide to start the BP treatment for women with a T-score <-2,0 or those with two or more clinical risk factors. The anti-RANK ligand antibody denosumab is also emerging as a adjuvant therapeutic option to prevent AI-induced bone loss and extend the time to first fracture in postmenopausal women treated with AIs.

Keywords:

antiresorptive therapies – aromatase inhibitors – breast cancer – osteoporosis


Sources
  1. Krásenská M. Léčba inhibitory aromatázy u postmenopuzálních pacientek s karcinomem prsu a možnosti ovlivnění nežádoucích účinků. Klin Oncol 2016; 29(Suppl 3): S39-S49.
  2. Winer EP. Optimizing endocrine therapy for breast cancer. J Clin Oncol 2005; 23(8): 1609–1610. Dostupné z DOI: <http://dx.doi.org/10.1200/JCO.2005.01.005>. Dostupné z DOI: <http:// 10.1200/JCO.2005.01.005>.
  3. Zekri J, Farag K. Assessment of bone health in breast cancer patients starting adjuvant aromatase inhibitors: a quality improvement clinical audit. J Bone Oncol 2016; 5(4): 159–162. Dostupné z DOI: <http://dx.doi.org/10.1016/j.jbo.2016.05.007>.
  4. Hadji P, Aapro MS, Body JJ et al. Management of Aromatase Inhibitor-Associated Bone Loss (AIBL) in postmenopausal women with hormone senzitive breast cancer: joint position statement of the IOF, CABS, ECTS, IEG, ESCEO IMS and SIOG. J Bone Oncol 2017; 7: 1–12. Dostupné z DOI: <http://dx.doi.org/10.1016/j.jbo.2017.03.001>.
  5. Milat F, Vincent AJ. Management of bone disease in women after breast cancer. Climacteric 2015; 18(Suppl 2): S47-S55. Dostupné z DOI: < http://dx.doi.org/10.3109/13697137.2015.1100383>.
  6. Amir E, Seruga B, Niraula S et al. Toxicity of adjuvant endocrine therapy in postmenopausal breast cancer patients: a systematic review and meta-analysis. J Natl Cancer Inst 2011; 103(17): 1299–1309. Dostupné z DOI: <http://dx.doi.org/10.1093/jnci/djr242>.
  7. Howell A, Cuzick J, Baum M et al. Results of the ATAC (Arimidex, Tamoxifen, Alone or in Combination) trial after completion of 5 years adjuvant treatment for breast cancer. Lancet 2005; 365(9453): 60–62. Dostupné z DOI: <http://dx.doi.org/10.1016/S0140–6736(04)17666–6>.
  8. Tremollieres FA. Screening for osteoporosis after breast cancer: for whom, why and when. Maturitas 2014; 79(3): 343–348. Dostupné z DOI: <http://dx.doi.org/10.1016/j.maturitas.2014.08.001>.
  9. Eastell R, Adams J, Clark G et al. Long-term effects of anastrozole on bone mineral density: 7- year results from the ATAC trial. Ann Oncol 2011; 22(4): 857–862. Dostupné z DOI: <http://dx.doi.org/10.1093/annonc/mdq541>.
  10. Hamood R, Hammod H, Merhasin I et al. Hormone therapy and osteoporosis in breast cancer survivors: assessment of risk and adherence to screening recommendations. Osteoporosis Int 2019; 30(1):187–200. Dostupné z DOI: <http://dx.doi.org/10.1007/s00198–018–4758–4>.
  11. Artigalas O, Vanni T, Hutz MH et al. Influence of CYP19A1 polymorphism on the treatment of breast cancer with aromatase inhibitors: a systematic review and meta-analysis. BMC Med 2015; 13: 139. Dostupné z DOI: <http://dx.doi.org/10.1186/s12916–015–0373–9>.
  12. Napoli N, Rastelli A, Ma C et al. Genetic polymorphism at Val80 (rs700518) of the CYP19A1 gene is associated with aromatase inhibitor associated bone loss in women with ER+ breast cancer. Bone 2013; 55(2): 309–314. Dostupné z DOI: <http://dx.doi.org/10.1016/j.bone.2013.04.021>.
  13. Oesterreich S, Henry NL, Kidwell KM et al. Associations between genetic variants and the effect of letrozole and exemestane on bone mass and bone turnover. Breast Cancer Res Treat 2015; 154(2): 263–273. Dostupné z DOI: <http://dx.doi.org/10.1007/s10549–015–3608–8>.
  14. Rodriguez-Sanz M, Garcia-Giralt N, Prieto-Alhambra D et al. CYP11A1 expression in bone is associated with aromatase inhibitor-related bone loss. J Mol Endocrinol 2015; 55(1): 69–79. Dostupné z DOI: <http://dx.doi.org/10.1530/JME-15–0079>.
  15. Liu M, Goss PE, Ingle JN et al. Aromatase inhibitor-associated bone fracture: a case-cohort GWAS and functional genomics. Mol Endocrinol 2014; 28(10): 1740–1751. Dostupné z DOI: <http://dx.doi.org/10.1210/me.2014–1147>.
  16. Mariotti V, Page DB, Davydov O et al. Assessing fracture risk in early stage breast cancer patients treated with aromatase-inhibitors: An enhanced screening approach incorporating trabecular bone score. J Bone Oncol 2016; 7: 32–37. Dostupné z DOI: <http://dx.doi.org/10.1016/j.jbo.2016.10.004>.
  17. Lester JE, Dodwell D, Horsman JM et al. Current management of treatment-induced bone loss in women with breast cancer in the United Kingdom. Br J Cancer 2006; 94(1): 30–35. Dostupné z DOI: <http://dx.doi.org/10.1038/sj.bjc.6602892>.
  18. Camacho PM, Dayal AS, Diaz JL et al. Prevalence of secondary causes of bone loss among breast cancer patients with osteopenia and osteoporosis. J Clin Oncol 2008; 26(33): 5380–5385. Dostupné z DOI: <http://dx.doi.org/10.1200/JCO.2008.17.7451>.
  19. Kling JM, Clarke BL, Sandhu NP. Osteoporosis prevention, screening, and treatment: a review. J Womens Health (Larchmt) 2014; 23(7): 563–572. Dostupné z DOI: <http://dx.doi.org/10.1089/jwh.2013.4611>.
  20. Wu H, Pang Q. The effect od vitamin D and calcium supplemention on falls in older adults: A systematic review and meta-analysis. Orthopade 2017; 46(9): 729–736. Dostupné z DOI: <http://dx.doi.org/10.1007/s00132–017–3446-y>.
  21. Datta M, Schwartz GG. Calcium and vitamin D supplementation and loss of bone mineral density in women undergoing breast cancer therapy. Crit Rev Oncol hematol 2013; 88(3): 613–624. Dostupné z DOI: <http://dx.doi.org/10.1016/j.critrevonc.2013.07.002>.
  22. Tabatabai LS, Bloom J, Stewart S et al. A Randomized Controlled Trial of Exercise to Prevent Bone Loss in Premenopausal Women with breast cancer. J Womens Health (Larchmt) 2019; 28(1): 87–92. Dostupné z DOI: <http://dx.doi.org/10.1089/jwh.2017.6863>.
  23. Safra T, Bernstein-Molho R, Greenberg J et al. The protective effect of zoledronic acid on bone loss in postmenopausal women with early breast cancer treated with sequencial tamoxifene and letrozole: a prospective, randomized, phase II trial. Oncology 2011; 81(5–6): 298–305. Dostupné z DOI: <http://dx.doi.org/10.1159/000334456>.
  24. Van Poznak C, Hannon RA, Mackey JR et al. Prevention of arDostupné z DOI: omatase inhibitor-induced bone loss using risedronate: the SABRE trial. J Clin Oncol 2010; 28(6): 967–975. Dostupné z DOI: <http://dx.doi.org/10.1200/JCO.2009.24.5902>.
  25. Bundred NJ, Campbell ID, Davidson N et al. Effective inhibition of aromatase inhibitor-associated bone loss by zoledronic acid in postmenopausal women with early breast cancer receiving adjuvant letrozole: ZO-FAST Study results. Cancer 2008; 112(5): 1001–1010. Dostupné z DOI: <http://dx.doi.org/10.1002/cncr.23259>.
  26. [Early Breast Cancer Trialists‘ Collaborative Group (EBCTCG)]. Adjuvant bisphosphonate treatment in early breast cancer: meta-analyses of individual patient data from randomised trials. Lancet 2015; 386(10001): 1353–1361. Dostupné z DOI: <http://dx,doi.org/10.1016/S0140–6736(15)60908–4>. Erratum in Lancet 2016; 387(10013): 30. Department of Error. [Lancet. 2017].
  27. Coleman RE, Marshall H, Cameron D et al. Breast cancer adjuvant therapy with zoledronic acid. N Engl J Med 2011; 365(15): 1396–1405. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1105195>.
  28. Sestak I, Singh S, Cuzick J et al. Changes in bone mineral density at 3 years in postmenopausal women receiving anastrozole and risedronate in the IBIS-II bone substudy: a international, double-blind, randomised, placebo-controlled trial. Lancet Oncol 2014; 15(13): 1460–1468. Dostupné z DOI: <http://dx.doi.org/10.1016/S1470–2045(14)71035–6>. Erratum in Lancet Oncol 2014; 15(13): e587.
  29. Markopoulos C, Tzoracoleftherakis E, Polychronis A et al. Management of anastrozole-induced bone loss in breast cancer patients with oral risedronate: results from the ARBI prospective clinical trial. Breast Cancer Res 2010; 12(2): R24. Dostupné z DOI: <http://dx.doi.org/10.1186/bcr2565>.
  30. Lester JE, Dodwell D, Purohit OP et al. Prevention of anastrozole-induced bone loss with monthly oral ibandronate during adjuvant aromatase inhibitor therapy for breast cancer. Clin Cancer Res 2008; 14(19): 6336–6342. Dostupné z DOI: <http://dx.doi.org/10.1158/1078–0432.CCR-07–5101>.
  31. Ellis GK, Bone HG, Chlebowski R et al. Randomized trial of denosumab in patients receiving adjuvant aromatase inhibitors for nonmetastatic breast cancer. J Clin Oncol 2008; 26(30): 4875–4882. Dostupné z DOI: <http://dx.doi.org/10.1200/JCO.2008.16.3832>.
  32. Gnant M, Pfeiler G, Dubsky PC et al. Adjuvant denosumab in breast cancer (ABCSG-18): a multicentre, randomized, double-blind, placebo-controlled trial. Lancet 2015; 386(9992):433–443. Dostupné z DOI: <http://dx.doi.org/10.1016/S0140–6736(15)60995–3>.
  33. Bayer M, Horák P, Palička V et al. Dlouhodobá léčba osteoporózy denosumabem a její přerušení: odborné stanovisko pracovní skupiny Společnosti pro metabolická onemocnění skeletu České lékařské společnosti J.E. Purkyně. Clin Osteol 2018; 23(1): 32–37.
Labels
Clinical biochemistry Paediatric gynaecology Paediatric radiology Paediatric rheumatology Endocrinology Gynaecology and obstetrics Internal medicine Orthopaedics Radiodiagnostics Rehabilitation Rheumatology Traumatology fenix.admin.empty
Login
Forgotten password

Don‘t have an account?  Create new account

Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account