Role of bone-modifying agents in metastatic breast cancer

An American Society of Clinical oncology-cancer Care Ontario focused guideline update

Catherine Van Poznak, Mark R. Somerfield, William E. Barlow, J. Sybil Biermann, Linda D. Bosserman, Mark J. Clemons, Sukhbinder K. Dhesy-Thind, Melissa S. Dillmon, Andrea Eisen, Elizabeth S. Frank, Reshma Jagsi, Rachel Jimenez, Richard L. Theriault, Theodore A. Vandenberg, Gary C Yee, Beverly Moy

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Purpose: To update, in collaboration with Cancer Care Ontario (CCO), key recommendations of the American Society of Clinical Oncology (ASCO) guideline on the role of bone-modifying agents (BMAs) in metastatic breast cancer. This focused update addressed the new data on intervals between dosing and the role of BMAs in control of bone pain. Methods: A joint ASCO-CCO Update Committee conducted targeted systematic literature reviews to identify relevant studies. Results: The Update Committee reviewed three phase III noninferiority trials of dosing intervals, one systematic review and meta-analysis of studies of de-escalation of BMAs, and two randomized trials of BMAs in control of pain secondary to bone metastases. Recommendations: Patients with breast cancer who have evidence of bone metastases should be treated with BMAs. Options include denosumab, 120 mg subcutaneously, every 4 weeks; pamidronate, 90 mg intravenously, every 3 to 4 weeks; or zoledronic acid, 4 mg intravenously every 12 weeks or every 3 to 4 weeks. The analgesic effects of BMAs are modest, and they should not be used alone for bone pain. The Update Committee recommends that the current standard of care for supportive care and pain management-analgesia, adjunct therapies, radiotherapy, surgery, systemic anticancer therapy, and referral to supportive care and pain management-be applied. Evidence is insufficient to support the use of one BMA over another.

Original languageEnglish (US)
Pages (from-to)3978-3986
Number of pages9
JournalJournal of Clinical Oncology
Volume35
Issue number35
DOIs
StatePublished - Dec 10 2017

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Medical Oncology
Ontario
Guidelines
Breast Neoplasms
Bone and Bones
Neoplasms
pamidronate
zoledronic acid
Pain Management
Pain
Neoplasm Metastasis
Standard of Care
Analgesia
Analgesics
Meta-Analysis
Radiotherapy
Referral and Consultation
Joints

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Van Poznak, C., Somerfield, M. R., Barlow, W. E., Biermann, J. S., Bosserman, L. D., Clemons, M. J., ... Moy, B. (2017). Role of bone-modifying agents in metastatic breast cancer: An American Society of Clinical oncology-cancer Care Ontario focused guideline update. Journal of Clinical Oncology, 35(35), 3978-3986. https://doi.org/10.1200/JCO.2017.75.4614

Role of bone-modifying agents in metastatic breast cancer : An American Society of Clinical oncology-cancer Care Ontario focused guideline update. / Van Poznak, Catherine; Somerfield, Mark R.; Barlow, William E.; Biermann, J. Sybil; Bosserman, Linda D.; Clemons, Mark J.; Dhesy-Thind, Sukhbinder K.; Dillmon, Melissa S.; Eisen, Andrea; Frank, Elizabeth S.; Jagsi, Reshma; Jimenez, Rachel; Theriault, Richard L.; Vandenberg, Theodore A.; Yee, Gary C; Moy, Beverly.

In: Journal of Clinical Oncology, Vol. 35, No. 35, 10.12.2017, p. 3978-3986.

Research output: Contribution to journalArticle

Van Poznak, C, Somerfield, MR, Barlow, WE, Biermann, JS, Bosserman, LD, Clemons, MJ, Dhesy-Thind, SK, Dillmon, MS, Eisen, A, Frank, ES, Jagsi, R, Jimenez, R, Theriault, RL, Vandenberg, TA, Yee, GC & Moy, B 2017, 'Role of bone-modifying agents in metastatic breast cancer: An American Society of Clinical oncology-cancer Care Ontario focused guideline update', Journal of Clinical Oncology, vol. 35, no. 35, pp. 3978-3986. https://doi.org/10.1200/JCO.2017.75.4614
Van Poznak, Catherine ; Somerfield, Mark R. ; Barlow, William E. ; Biermann, J. Sybil ; Bosserman, Linda D. ; Clemons, Mark J. ; Dhesy-Thind, Sukhbinder K. ; Dillmon, Melissa S. ; Eisen, Andrea ; Frank, Elizabeth S. ; Jagsi, Reshma ; Jimenez, Rachel ; Theriault, Richard L. ; Vandenberg, Theodore A. ; Yee, Gary C ; Moy, Beverly. / Role of bone-modifying agents in metastatic breast cancer : An American Society of Clinical oncology-cancer Care Ontario focused guideline update. In: Journal of Clinical Oncology. 2017 ; Vol. 35, No. 35. pp. 3978-3986.
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