The results of this small study add an other hint to the growing evidence that bisphosphonates such as Clodronate are not only beneficial in terms of bone strength but under certain conditions may also have antitumor activity in bones.
Since bone cancer may result in remote dissemination of metastases, bisphosphonates may indirectly prevent or delay visceral metastases.
http://www.ncbi.nlm.nih.gov/entrez/q...=pubmed_DocSum
Oral bisphosphonates as adjuvant therapy for operable breast cancer.
Powles T,
McCroskey E,
Paterson A Authors' Affiliations: Parkside Oncology Clinic, London, United Kingdom.
Bone is the most common site of metastatic spread from primary operable breast cancer, causing pain, fractures, and hypercalcemia. This spread depends on the release of osteolytic substances by the cancer cells, which activate osteoclasts to cause bone resorption. The osteoclasts also release growth factors that can act back on the cancer cells to activate growth. This vicious circle thereby facilitates the growth of metastases in bone, thus making this a preferential site for relapse. Agents, such as the bisphosphonates, which block osteoclast function, have been shown to reduce the progression of established bone metastases. The oral bisphosphonate clodronate (1,600 mg/d) is effective for treatment of patients with bone metastases. When used as adjuvant therapy, given to patients with operable breast cancer for 2 years, clodronate has been reported to significantly reduce the risk of bone metastases during the 2-year study period [19 clodronate patients versus 35 placebo patients; hazard ratio (HR), 0.546; P = 0.03] and 5-year study period (51 clodronate patients versus 73 placebo patients; HR, 0.692; P = 0.04) with a significant reduction in mortality (HR, 0.768; P = 0.048). This benefit, together with the low toxicity and safety of clodronate, supports its use as additional adjuvant therapy for patients with primary breast cancer. Further, similarly designed trials are under way to establish the optimal duration of therapy, the efficacy in stage I disease, and the relative potential of other bisphosphonates, particularly the more powerful aminobisphosphonates, such as ibandronate and zoledronate.
PMID: 17062718 [PubMed - in process]
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