scholarly journals Bone turnover markers in postmenopausal breast cancer treated with fulvestrant – A pilot study

The Breast ◽  
2009 ◽  
Vol 18 (3) ◽  
pp. 204-207 ◽  
Author(s):  
A. Agrawal ◽  
R.A. Hannon ◽  
K.L. Cheung ◽  
R. Eastell ◽  
J.F.R. Robertson
2020 ◽  
Author(s):  
Hideo Shigematsu ◽  
Tomoyuki Yoshiyama ◽  
Daisuke Yasui ◽  
Shinji Ozaki

Abstract Background: Osteoporosis and fractures are important aromatase inhibitor (AI) related adverse events in postmenopausal women with hormone receptor positive breast cancer. An increment of pentosidine is associated with a deterioration of bone quality. In this study, pentosidine was evaluated in postmenopausal breast cancer patients receiving AIs. Methods: Fifty postmenopausal breast cancer patients receiving AIs were retrospectively evaluated. Sixteen patients were given a bone modifying agent (BMA) concomitant with AIs. Changes of pentosidine, bone turnover markers and bone mineral density (BMD) before and after 12 months of AI therapy were compared between BMA administered patients (BMA group) and a non-BMA group.Results: There was no significant difference between pentosidine low and high groups in regard to age, height, weight, BMD of femoral neck and lumbar spine, and bone turnover markers including TRACP-5b and BAP. In the non-BMA group, pentosidine was increased in 18 cases (53%), and the average change of pentosidine was 21.5% (95%CI; 0.23 to 42.7%, p=0.048). In the BMA group, pentosidine was increased in 2 two cases (13%), and the average change of pentosidine was -16.6% (95%CI; -30.6 to -2.6%, p=0.023). There was a significantly lower proportion of pentosidine-increased cases (p=0.0065) and decrease of pentosidine (p=0.021) in the BMA group compared to those in the non-BMA group. Conclusions: Pentosidine was an independent factor from risk factors of osteoporotic fracture. Pentosidine was increased with AI, however, BMA inhibits an AI-induced increase of pentosidine in postmenopausal breast cancer patients.


2020 ◽  
Author(s):  
Hideo Shigematsu ◽  
Tomoyuki Yoshiyama ◽  
Daisuke Yasui ◽  
Shinji Ozaki

Abstract Background: Osteoporosis and fractures are important aromatase inhibitor (AI) related adverse events in postmenopausal women with hormone receptor positive breast cancer. An incremental increase of pentosidine is associated with a deterioration of bone quality. In this study, pentosidine was evaluated in postmenopausal breast cancer patients receiving AIs.Methods: Fifty Japanese postmenopausal breast cancer patients receiving AIs were retrospectively evaluated. Sixteen patients were given a bone modifying agent (BMA) concomitant with AIs. Changes of pentosidine, bone turnover markers and bone mineral density (BMD) before and after 12 months of AI therapy were compared between BMA administered patients (BMA group) and a non-BMA group. These factors were assessed by BMA groups using chi-square of categorical variables and t-test for continuous variables.Results: The median age of the subjects was 67 years, and 21, 23 and 6 subjects were classified as normal, bone loss and osteoporosis, respectively. There was no significant difference between pentosidine low and high groups in regard to age, height, weight, BMD of femoral neck and lumbar spine, and bone turnover markers including TRACP-5b and BAP. In the non-BMA group, pentosidine was increased in 18 cases (53%), and the average change of pentosidine was 21.5% (95%CI; 0.23 to 42.7%, p=0.048). In the BMA group, pentosidine was increased only in 2 cases (13%), and the average change of pentosidine was -16.6% (95%CI; -30.6 to -2.6%, p=0.023). There was a significantly lower proportion of pentosidine-increased cases (p=0.0065) and decrease of pentosidine (p=0.021) in the BMA group compared to those in the non-BMA group.Conclusions: Pentosidine was increased with AI, however, BMA inhibits an AI-induced increase of pentosidine in postmenopausal breast cancer patients.


2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 680-680
Author(s):  
A. Agrawal ◽  
R. A. Hannon ◽  
K. L. Cheung ◽  
R. Eastell ◽  
J. F. Robertson

680 Background: Aromatase inhibitor (AI) therapy in patients with breast cancer accelerates bone turnover with increased secretion and excretion of bone turnover markers. Here, we report the effect of fulvestrant, an estrogen receptor (ER) antagonist with no agonist activity, on bone metabolism. Methods: 23 patients with either locally advanced primary [LAPC] or metastatic [MBC] disease who had clinical benefit (objective response/stable disease ≥6 months) during fulvestrant therapy were included in the study. Sequential tumor biopsies and blood samples were taken at baseline and after 3, 6, 9, 12 and 18 months of fulvestrant treatment (disease being stable throughout the study period). Serum was analyzed for bone formation markers (N-terminal propeptide of procollagen Type 1 [PINP] and bone-specific alkaline phosphatase [bone ALP]) and for the resorption marker C-terminal telopeptide (CTX). Data are presented as median percentage change (from baseline) in marker level with 95% confidence intervals (CI). Data were analyzed separately for patients with LAPC and MBC. Results: Changes in bone ALP (reference range: 3.9–46.8 ng/mL), PINP (20.6–82.1 ng/mL) and CTX (0.14–1.35 ng/mL) in patients with LAPC, are shown in the table . In a further 5 patients with LAPC who were already established on fulvestrant, there were no significant changes in markers over a 15-month period. No changes in markers were noted in the 4 patients with MBC. Conclusions: In this study, there was long-term stability of bone turnover markers in postmenopausal women with LAPC treated with fulvestrant over a period of 18 months. This property may be exploited in future with the use of fulvestrant earlier in the sequence of endocrine therapies particularly in the adjuvant setting and/or in patients with pre-existing decreased bone mass. [Table: see text] [Table: see text]


The Breast ◽  
2007 ◽  
Vol 16 ◽  
pp. S53 ◽  
Author(s):  
J.F.R. Robertson ◽  
A. Agrawal ◽  
R.A. Hannon ◽  
K.L. Cheung ◽  
R. Eastell

2009 ◽  
Vol 19 (1) ◽  
pp. 63-68 ◽  
Author(s):  
Judith Balk ◽  
Melissa Gluck ◽  
Lisa Bernardo ◽  
Janet Catov

Weight-bearing exercise is recommended to improve bone density. Hatha Yoga is a popular form of weight-bearing exercise that includes physical postures, stretching, breathing, and relaxation. We hypothesized that Hatha Yoga would have beneficial effects on bone turnover markers. We conducted a small feasibility pilot study with a prospective, pre-post design comparing markers of bone turnover before and after Yoga training in sedentary osteopenic postmenopausal women. Markers of bone formation were measured with serum bone-specific alkaline phosphatase (BAP). Measures of bone resorption were measured with urinary type I collagen cross-linked N-telopeptide (uNTX). Seven participants completed a 12-week series of one hour per week Yoga classes, in addition to home Yoga practice. We analyzed the correlation between time spent on Yoga and time spent on other weight-bearing exercise and change in bone turnover markers. The amount of Yoga practice was significantly correlated with BAP levels (r = 0.68, p = 0.09). A weaker, non-significant correlation was found between the amount of Yoga practice and uNTX levels (r = -.54, p = .21). Compared to Yoga, other physical activities were less correlated with BAP and uNTX levels. Yoga may have beneficial effects on bone turnover in osteopenic postmenopausal women.


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