Evaluation of Pentosidine as Bone Quality Marker in Postmenopausal Breast Cancer Patients Receiving Aromatase Inhibitors

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.

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Evaluation of Pentosidine as Bone Quality Marker in Postmenopausal Breast Cancer Patients Receiving Aromatase Inhibitors

10.21203/rs.3.rs-42565/v2 ◽

2020 ◽

Author(s):

Hideo Shigematsu ◽

Tomoyuki Yoshiyama ◽

Daisuke Yasui ◽

Shinji Ozaki

Keyword(s):

Breast Cancer ◽

Bone Turnover ◽

Cancer Patients ◽

Bone Quality ◽

Bone Turnover Markers ◽

Postmenopausal Breast Cancer ◽

Categorical Variables ◽

Breast Cancer Patients ◽

Average Change ◽

Turnover Markers

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.

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Influence of adjuvant tamoxifen treatment on bone mineral density and bone turnover markers in postmenopausal breast cancer patients in Japan

Cancer Letters ◽

10.1016/s0304-3835(02)00345-2 ◽

2002 ◽

Vol 186 (2) ◽

pp. 223-230 ◽

Cited By ~ 24

Author(s):

Kohri Yoneda ◽

Yoshio Tanji ◽

Noriko Ikeda ◽

Yasuo Miyoshi ◽

Tetsuya Taguchi ◽

...

Keyword(s):

Breast Cancer ◽

Bone Mineral Density ◽

Bone Turnover ◽

Cancer Patients ◽

Bone Turnover Markers ◽

Postmenopausal Breast Cancer ◽

Tamoxifen Treatment ◽

Breast Cancer Patients ◽

Mineral Density ◽

Turnover Markers

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P140 Bone turnover markers in postmenopausal breast cancer patients treated with fulvestrant

The Breast ◽

10.1016/s0960-9776(07)70200-x ◽

2007 ◽

Vol 16 ◽

pp. S53 ◽

Cited By ~ 1

Author(s):

J.F.R. Robertson ◽

A. Agrawal ◽

R.A. Hannon ◽

K.L. Cheung ◽

R. Eastell

Keyword(s):

Breast Cancer ◽

Bone Turnover ◽

Cancer Patients ◽

Bone Turnover Markers ◽

Postmenopausal Breast Cancer ◽

Breast Cancer Patients ◽

Turnover Markers

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Bone turnover markers in postmenopausal breast cancer patients treated with fulvestrant

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.680 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 680-680

Author(s):

A. Agrawal ◽

R. A. Hannon ◽

K. L. Cheung ◽

R. Eastell ◽

J. F. Robertson

Keyword(s):

Breast Cancer ◽

Bone Turnover ◽

Bone Turnover Markers ◽

Objective Response ◽

Locally Advanced ◽

Postmenopausal Breast Cancer ◽

Breast Cancer Patients ◽

Median Percentage ◽

Bone Formation Markers ◽

Turnover Markers

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]

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