Therapeutic Bone-Modifying Agents in the Nonmetastatic Breast Cancer Setting: The Controversy and a Value Assessment

2017 ◽  
pp. 116-122
Author(s):  
Michael Gnant ◽  
Catherine Van Poznak ◽  
Lowell Schnipper
Keyword(s):  
Breast Cancer ◽  
Bisphosphonate Therapy ◽  
Value Assessment ◽  
A Value ◽  
Breast Cancer Outcomes ◽  
Primary Endpoints ◽  
Adjuvant Breast Cancer ◽  
Pros And Cons ◽  
Cancer Setting ◽  
Meta Analyses

Clinical trials and meta-analyses investigating bisphosphonates as an adjuvant breast cancer therapy have shown a consistent trend, with postmenopausal women and women receiving ovarian suppression with gonadotropin-releasing hormone therapy gaining improved breast cancer outcomes with the use of adjuvant bisphosphonate therapy. The interpretation of these data is controversial, because the primary endpoints of the majority of adjuvant bisphosphonate studies have been negative. Pros and cons as well as the value of adjuvant bisphosphonate therapy are discussed here.

scholarly journals Cost-Utility Analysis of Newer HER2- Testing Technologies to Target Trastuzumab in the Adjuvant Breast Cancer Setting

2014 ◽  
Vol 17 (3) ◽  
pp. A90
Author(s):  
I.L. Ferrusi ◽  
N.A. Kulin ◽  
R. Goeree ◽  
N. Leighl ◽  
E.M. Pullenayegum ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cost Utility ◽  
Cost Utility Analysis ◽  
Utility Analysis ◽  
Her2 Testing ◽  
Adjuvant Breast Cancer ◽  
Cancer Setting

Canadian pattern of care for anemia: comparison of chemotherapies in adjuvant breast cancer setting.

2009 ◽  
Author(s):  
A Quinn ◽  
C Wong ◽  
J Younus ◽  
G Dranitsaris ◽  
R Goel ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Pattern Of Care ◽  
Adjuvant Breast Cancer ◽  
Cancer Setting

Taxanes in adjuvant breast cancer setting: Which standard in Europe?

2005 ◽  
Vol 55 (3) ◽  
pp. 167-175 ◽  
Author(s):  
Mario Campone ◽  
Pierre Fumoleau ◽  
Emmanuelle Bourbouloux ◽  
Pierre Kerbrat ◽  
Henri Roché
Keyword(s):  
Breast Cancer ◽  
Adjuvant Breast Cancer ◽  
Cancer Setting

Relationship between CYP2D6 and estrogen receptor alpha polymorphisms on tamoxifen metabolism in adjuvant breast cancer treatment

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 505-505 ◽  
Author(s):  
J. L. Grabinski ◽  
L. S. Smith ◽  
G. B. Chisholm ◽  
R. Drengler ◽  
G. I. Rodriguez ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Estrogen Receptor ◽  
Estrogen Receptor Alpha ◽  
Cyp2d6 Genotype ◽  
Allelic Discrimination Assay ◽  
Allelic Discrimination ◽  
Breast Cancer Outcomes ◽  
Tamoxifen Metabolism ◽  
Adjuvant Breast Cancer ◽  
Er Alpha

505 Background: Tamoxifen (TAM) and its metabolites display large inter-individual variation with profound implications for breast cancer outcomes. Tamoxifen is hydroxylated to the potent metabolites, 4-hydroxytamoxifen (4-OH TAM) and endoxifen, by various cytochrome P450 (CYP450) genes including CYP2C9 and CYP2D6. The SULT1A1 gene is involved in the conjugation of 4-OH TAM. Tamoxifen’s binding site is the estrogen receptor (ER). Methods: Clinical data and blood samples were collected for 301 patients (299 female, 2 male) receiving at least 8 weeks of adjuvant tamoxifen therapy. HPLC analysis assessed TAM, N-desmethyltamoxifen (N-DMT), and 4-OH TAM levels. Genotyping of the CYP2C9 (*2,*3), CYP2D6 (*2, *3, *4, *6, *7, *8, *14) and SULT1A1 (*2) genes was determined by Pyrosequencing. CYP2D6 genotypes were subdivided into poor (PM), intermediate (IM), and extensive (EM) metabolizers. Genotyping of ER alpha polymorphisms, Pvu II and Xba I, utilized a Taqman Allelic Discrimination Assay. The Wilcoxon Rank Sum test was used to test associations of genotype and quantitative metabolite levels, within genotype associations, and ethnicity. Results: The majority of our patients were Caucasian (68%) and Hispanic (26%). The mean (± SD) levels for TAM, 4-OH TAM and N-DMT were 111.7 (± 58.4 ng/ml), 2.2 (± 1.5 ng/ml) and 204.7 (± 104.1 ng/ml), respectively. The CYP2D6 genotype was statistically associated with 4-OH TAM levels (p=0.0002). Differences were detected between EM and PM (p=0.0001) and IM and PM (p=0.0029). ER alpha Pvu II genotypes were shown to influence TAM levels (p=0.02). Significant differences were identified between the PP and Pp genotypes (p=0.0064) and between PP and pp genotypes (p=0.03). Hispanics had significantly higher levels of TAM (p=0.02) and 4-OH TAM (p=0.007) than Caucasians. Conclusions: Genotype and ethnicity are significantly associated with levels of TAM and 4-OH TAM and may explain clinical variation in response to TAM treatment. No significant financial relationships to disclose.

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