Interesting article/clinical trial/preventing bone mets stage I-III

[CherylS]

Found this article interesting. My onc is considering it.



http://www.komen.org/intradoc-cgi/idc_cgi_isapi.dll?IdcService=SS_GET_PAGE&nodeId=328&XMLFile=breast_mar06_10&XSLFile=ccArticleXSLT&useSecondary=true

[Cathya]

Cheryl;

Yes, it is a very interesting article. I am going to bring it to my onc appt. next week. Thanks for adding it.

Best regards,

Cathya

[Ginagce]

Thanks for posting.

Ginagce

[jjfromcanada]

I found an article about a small study back in 2003 reporting a decrease in bone mets with chlodronate and asked my oncolgist about it then. He prescribed it and I have been taking it ever since.

No side effects and no bone mets so far.

Diagnosed April 2002, two primaries same breast, larger 4.5 cm. ER/PR-, HER2+, 4 lymph nodes, Grade III.

Go for it.

[suzan w]

Thanks for this article, I, too, will take it to my onc next week!

[saleboat]

Wow. Thanks for posting. I've been following this, but didn't know that a new study was out. Wonder if it is considered definitive. I know that clod is rx'd in Europe and Canada but not approved here. The studies thus far have been mixed-- breastcancer.org has a good summary of the findings. There was some evidence that this tx was not for hormonal negative bc, but hopefully that has been cleared-up with this study.


http://www.breastcancer.org/research_recurrence_bisphosphonates.html

[CherylS]

It looks like according to the breastcancer.org info that chlodronate is not available in the US yet, only in Canada. JJ, I see that is where you are from. Anyone know how to get meds from Canada?

[saleboat]

I had a US based Onc recommend it to me 'off label', but I'd have to get it from Canada, which one can do, but it was a cumbersome process requiring some legal paperwork. Now that this study is out, I hope it will be definitive and US Oncs will go ahead and rx it as 'protocal'. I see my Onc in two weeks, and will be sure to ask about this. Would be nice to have another arrow in the quiver.

Jen

[Barbara2]

Clodronate was used in the clinical trial that was made reference to above, but why not ask for any of the other types of bisphosphonates such as Fosamax or Actonel?

Aredia and Zometa ( both intravenous) are used in metastatic breast cancer as was Clodronate.

"The researchers concluded that these results add to findings indicating that the use of bisphosphonates such as Clodronate in the treatment of early breast cancer appears to resist the risk of bone metastasis and may affect survival in some patients. Further study is necessary to determine how to incorporate bisphosphonates into the treatment of earlier stages of cancer."

Barbara

[CherylS]

I talked to my onc. pharmacist today and he had done some checking for me. He said that clodronate was submitted for approval to the FDA in Jan. of 2005,
nothing further. Go figure. The other's, Aredia and Zometra are intraveneous drugs and insurance won't cover them unless bone mets have already occurred. Clodronate is an oral medication. Again, go figure. He said that the FDA requires two conclusive clinical trials. Looks like we've got those, so what's the problem? Almost 1 1/2 years after submittal for approval we have nothing.

[sassy]

My onc has suggest we appeal to my insurance company to pay for Zometa since I have had significant problems with Femara. I am 46, er+/pr+/her2+++, taking Lupron to keep me postmeno and on Arimidex, thus the need for something to help my bones. After reading this, I am really going to push for Zometa.

Sassy
________
Pattaya realty (http://pattayaluxurycondos.com)

[Unregistered]

I've said it before, docs like drugs which are infused since they make more money from them for their clinics.

[jeff]

I guess I 'm confused by the rush to clodronate, because my understanding is that it is used in Europe and Canada only because some of the newer and more powerful agents available in the US are not approved there.

In other words, women in the US might be just as well served to ask for fosamax or actonel...

Jeff

[saleboat]

Hi,

I think the real question is whether or not bisphosphanates are going to become standard of care for early-stage bc patients for prevention of bone mets. As it stands, this type of therapy is only available off-label/protocal for prevention of mets for early-stagers. Has anyone heard anything different given the study that was posted?

Jen

[AlaskaAngel]

I don't know how interchangeable the "bisphosphonates" are since they are not all the same. Fosamax and Actonel are quite commonly prescribed for osteoporosis whether or not a person has cancer and Boniva is newer but akin to them. So... whether or not they all would do the trick or not, or whether some would and some wouldn't, is the question, since the info was based on clodronate -- and some seem to be more focused on use for malignancy than others....

???

Fosamax (alendronate sodium) - tablets, oral solution - bone resorption inhibitor for Paget disease and corticosteroid-induced or age-related osteoporosis in men and women; investigational (orphan) for bone manifestations of Gaucher disease and pediatric osteogenesis imperfecta

Actonel (risedronate sodium) - tablets - bisphosphonate bone resorption inhibitor for osteoporosis and Paget disease

Boniva (ibandronate sodium) - tablets, IV - bisphosphonate bone resorption inhibitor for postmenopausal osteoporosis; also used for metastatic bone disease

clodronate disodium - bisphosphonate bone resorption inhibitor for hypercalcemia of malignancy

Aredia (pamidronate disodium) - IV - bisphosphonate bone resorption inhibitor for Paget disease, hypercalcemia of malignancy, breast cancer, and multiple myeloma

Zometa (zoledronic acid) - IV - bone resorption inhibitor for hypercalcemia of malignancy, multiple myeloma, bone metastasis, and metabolic bone disorders such as Paget's disease

[Unregistered]

Cheryl S

My insurance covered Zometa for infusion due to osteopenia. I am getting every 3 week Herceptin (as an adjuvant) and got my ovaries removed to be able to take Arimidex. At that time, my gyno ordered a bone density and I was in the beginning phase of osteopenia. He said that since I was still getting IV drugs, might as well talk to my onc on getting Zometa every 6 months. Got the first one in November and the second will be in May. After that, I will have to probably go on something in November since Herceptin will be well over by then (unless ASCO comes out with something about a second year as my first year is up in mid June).

So... some insurance will approve for other reasons. Mine did.

Best regards,

Becky

[Lauriemn]

To Cheryl or anyone else that has asked their onc about use of bisphosphonates, Has anyone started taking any? I have my Herceptin next week and will ask my onc then. If you have, which one are you taking?


thanks, Laurie

[CherylS]

My onc. has ordered a bone density test for me because any sign of loss would justify one of the infusion bisphosphonates to insurance. Not that I want to have bone density loss, but honestly I am kind of hoping for a little so that I can get one of these drugs.