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Oral Ibandronate Offers Palliative Benefits to Patients Who Progress on First-Line Bisphosphonate Therapy: Presented at SABCS

By Charlene Laino

SAN ANTONIO, TX -- December 19, 2006 -- Second-line therapy with oral ibandronate can provide significant palliative benefits to patients with metastatic breast cancer who have bony progression or a skeletal-related event on first-line bisphosphonate therapy, a prospective study suggests.

Mark Clemons, MD, head, Breast Medical Oncology, Princess Margaret Hospital, Toronto, Ontario, Canada, presented the results here on December 15^th at the 29^th Annual San Antonio Breast Cancer Symposium (SABCS).

Dr. Clemons said that in Canada, the most commonly used bisphosphonates are oral clodronate and intravenous pamidronate, with therapy typically maintained until end of life in 90% of patients. But a substantial number of patients with metastatic breast cancer have bony progression or develop a skeletal-related event despite the therapy. For such women, the optimal management strategy is not known, he said.

The new study evaluated the impact of 12 weeks of second-line treatment with 50 mg/day of oral ibandronate on pain control and bone turnover in 30 patients with metastatic breast cancer. Of the total, 7 patients had been on clodronate and 23 on pamidronate. Fifteen women had progressive bone disease and 15 had skeletal-related events. Their median age was 57 years.

By week 12, patients experienced a statistically significant improvement in pain control on the Brief Pain Inventory (P = .013), Dr. Clemons reported. Of 26 evaluable patients, 46.2% achieved a palliative response, defined as a reduction of at least 2 points from their worst pain score.

There was also a statistically significant reduction in bone turnover, reflected by a median 35% reduction in urinary N-telopeptide levels relative to baseline (P < .01), he said.

Of the 23 patients who initially received intravenous pamidronate, 87.0% said they preferred oral therapy.

"In clinical practice, most patients with bony progression or skeletal-related events are maintained on the same bisphosphonate with any supportive evidence," Dr. Clemons said. "If these findings are confirmed through randomized trials, clinicians can start breaking away from this paradigm."


[Presentation title: Oral Ibandronate Provides Significant Palliative Benefit in Metastatic Breast Cancer Patients Who Have Experienced Bony Progression or a Skeletal Related Event (SRE) Despite First-Line Bisphosphonate Therapy. Abstract 3147]

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