Assessment and management of bone health in women with early breast cancer receiving endocrine treatment in the DATA study.

Autor: van Hellemond IEG; Department of Medical Oncology, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, the Netherlands., Smorenburg CH; Department of Internal Medicine, Medical Centre Alkmaar, Alkmaar, the Netherlands., Peer PGM; Biostatistics, Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, the Netherlands., Swinkels ACP; Clinical research department, Netherlands Comprehensive Cancer Organisation IKNL, Utrecht, the Netherlands., Seynaeve CM; Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands., van der Sangen MJC; Department of Radiation Oncology, Catharina Hospital, Eindhoven, the Netherlands., Kroep JR; Department of Medical Oncology, Leiden University Medical Centre, Leiden, the Netherlands., de Graaf H; Department of Medical Oncology, Medical Centre Leeuwarden, Leeuwarden, the Netherlands., Honkoop AH; Department of Medical Oncology, Isala Clinics, Zwolle, the Netherlands., Erdkamp FLG; Department of Medical Oncology, Zuyderland Medical Centre, Sittard, the Netherlands., van den Berkmortel FWPJ; Department of Medical Oncology, Zuyderland Medical Centre, Sittard, the Netherlands., de Boer M; Department of Medical Oncology, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, the Netherlands., de Roos WK; Department of Surgery, Gelderse Vallei Hospital, Ede, the Netherlands., Linn SC; Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands., Imholz ALT; Department of Medical Oncology, Deventer Hospital, Deventer, the Netherlands., Tjan-Heijnen VCG; Department of Medical Oncology, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, the Netherlands.
Jazyk: angličtina
Zdroj: International journal of cancer [Int J Cancer] 2019 Sep 01; Vol. 145 (5), pp. 1325-1333. Date of Electronic Publication: 2019 Mar 04.
DOI: 10.1002/ijc.32205
Abstrakt: The phase III DATA study investigates the efficacy of adjuvant anastrozole (6 vs. 3 year) in postmenopausal women with breast cancer previously treated with 2-3 years of tamoxifen. This planned side-study assessed patterns of care regarding detection and treatment of osteopenia/osteoporosis, and trends in bone mineral density (BMD) during and after therapy. We registered all BMD measurements and bisphosphonate-use. Time to osteopenia/osteoporosis was analysed by Kaplan Meier methodology. For the trend in T-scores we used linear mixed models with random patients effects. Of 1860 eligible DATA patients, 910 (48.9%) had a baseline BMD measurement. Among patients with a normal baseline BMD (n = 417), osteopenia was observed in 53.5% and 55.4% in the 6- and 3-year group respectively (p = 0.18), during follow-up. Only two patients (3-year group) developed osteoporosis. Of the patients with osteopenia at baseline (n = 408), 24.4% and 20.4% developed osteoporosis respectively (p = 0.89). Three years after randomisation 18.3% and 18.2% used bisphosphonates in the 6- and 3-year groups respectively and 6 years after randomisation this was 23.7% and 20.9% respectively (p = 0.90) of which the majority used oral bisphosphonates. The yearly mean BMD-change during anastrozole in the lumbar spine showed a T-score decline of 0.075. After bisphosphonate addition the decline became less prominent (0.047 (p < 0.001)) and after anastrozole cessation, while continuing bisphosphonates, the mean BMD yearly increased (0.047 (p < 0.001)). In conclusion, extended anastrozole therapy was not associated with a higher incidence of osteoporosis. Anastrozole-use was associated with a BMD decrease; however, the decline was modest and partially reversible after anastrozole cessation.
(© 2019 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.)
Databáze: MEDLINE
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