Bone turnover markers in postmenopausal breast cancer treated with fulvestrant--a pilot study.

Abstract

BACKGROUND:

Tamoxifen has a protective effect on bone metabolism in breast cancer; aromatase inhibitors deleterious and that of fulvestrant is unknown.

METHODS:

Fourteen locally advanced breast cancers with clinical benefit on fulvestrant (250 mg/month) as first-line primary endocrine therapy had sequential serum bone-specific alkaline phosphatase (BAP), N-terminal propeptide of procollagen type 1 (PINP) and C-terminal telopeptide (CTX) at 0, 1, 6, 12, and 18 months. Mean percentage changes (95% CI) were calculated.

RESULTS:

Changes from baseline at 1, 6, 12, and 18 months with BAP (3.9-46.8 ng/ml) were +1.5 (-9.8 to +12.9), +2.2 (-22.1 to +26.6), +17.6 (-12.4 to +47.6), +10.8 (-29.9 to +51.7); with PINP (20.6-82.1 ng/ml) were +3.4 (-12.0 to 19.0), +18.8 (-36.7 to +74.2), +47.5 (-21.4 to 116.3), +33.3 (-49.5 to +116.1) and with CTX (0.14-1.35 ng/ml) were +30.8 (0.1 to +61.6), +13.9 (-22.3 to +50.2), +42.9 (-12.7 to +98.5), +45.2 (-28.3 to +118.8).

CONCLUSIONS:

Long-term (18 months) stability of bone markers may be exploited by using fulvestrant earlier in sequence of endocrine therapies particularly in adjuvant setting in those with pre-existing decreased bone mass.

• Authors: A Agrawal, R A Hannon, K L Cheung, R Eastell, J F R Robertson
• Journal: Breast (Edinburgh, Scotland) (Breast) Vol. 18 Issue 3 Pg. 204-7 (Jun 2009) ISSN: 1532-3080 [Electronic] Netherlands
• PMID: 19464177 (Publication Type: Controlled Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antineoplastic Agents
• Biomarkers
• Collagen Type I
• Peptides
• collagen type I trimeric cross-linked peptide
• Fulvestrant
• Estradiol
• Alkaline Phosphatase

Topics

• Aged
• Alkaline Phosphatase (blood)
• Antineoplastic Agents (administration & dosage)
• Biomarkers (blood)
• Bone Density (drug effects)
• Bone Remodeling (drug effects)
• Bone Resorption (chemically induced, prevention & control)
• Breast Neoplasms (drug therapy)
• Collagen Type I (blood)
• Estradiol (administration & dosage, analogs & derivatives)
• Female
• Fulvestrant
• Humans
• Middle Aged
• Peptides (blood)
• Pilot Projects
• Postmenopause (blood)
• Treatment Outcome