Abstract P5-13-04: Use of Bisphosphonates in the Adjuvant Setting for Breast Cancer — A More Than 10 Years Single Centre Experience

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Abstract Background: Adjuvant therapies for early breast cancer are associated with substantial decrease in bone mineral density. Bisphosphonates are antiresorptive agents that have an established role in preventing skeletal morbitity in patients with bone metastases and in the treatment of osteoporosis. It has also been shown that these agents are active in preventing cancer treatment induced bone loss in women with early stage breast cancer. Recently, several trials have demonstrated that bisphosphonates may exert anticancer effects in the adjuvant setting. Patients and methods: Since 1997 we treated an increasing number of unselected patients with early breast cancer with bisphosphonates (up to 2009: 1144 out of 1876 patients). There was no significant difference in the two patient groups concerning tumour size, nodal status, hormone receptor (HR) expression, HER-2 expression and adjuvant treatment modalities. In most cases we used zoledronic acid, but also clodronate ibandronate or alendronate. Results: Disease-free survival (DFS) was significant better in patients treated with bisphosphonates (p = 0.009). This was also true in the subgroup of patients with hormone receptor positive disease (p=0.0011) and even more striking in patients with N+ disease (p=0.00003). There was no significant difference in DFS in patients with hormone receptor negative disease. In our analyses especially patients with N+ and ER/PR+ disease showed a significant advantage from treatment with bisphosphonates. Conclusion: This large single centre experience demonstrates a significant improvement of disease-free survival in patients with breast cancer treated with bisphosphonates in the adjuvant setting. The benefit was more pronounced in the subgroup of nodal positive and hormone receptor positive disease. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P5-13-04.

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