The impact of mammalian target of rapamycin inhibition on bone health in postmenopausal women with hormone receptor-positive advanced breast cancer receiving everolimus plus exemestane in the phase IIIb 4EVER trial.

25-OH-vitamin D, 25-hydroxyvitamin D Art, antiresorptive therapy BSAP, bone-specific alkaline phosphatase Bone health Bone marker Breast cancer CI, confidence interval CR, complete response CTX, C-terminal cross-linking telopeptide of type 1 collagen Everolimus HER2-negative, human epidermal growth factor receptor 2-negative HR, hazard ratio HR +, hormone receptor-positive Hormone receptor-positive Mammalian target of rapamycin NSAI, non-steroidal aromatase inhibitor OR, overall response ORR, overall response rate ORR24w, overall response rate within the first 24 weeks of treatment P1NP, procollagen type 1 N-terminal peptide PFS, progression-free survival PR, partial response PTH, parathyroid hormone SD, standard deviation SRE, skeletal-related event mTOR, mammalian target of rapamycin

Journal

Journal of bone oncology
ISSN: 2212-1366
Titre abrégé: J Bone Oncol
Pays: Netherlands
ID NLM: 101610292

Informations de publication

Date de publication:
Feb 2019
Historique:
received: 07 08 2018
revised: 26 09 2018
accepted: 26 09 2018
entrez: 6 12 2018
pubmed: 6 12 2018
medline: 6 12 2018
Statut: epublish

Résumé

Breast cancer and its treatments are associated with a detrimental effect on bone health. Here we report the results of an exploratory analysis assessing changes in levels of biomarkers of bone metabolism in patients enrolled in the phase IIIb 4EVER study. The 4EVER trial investigated everolimus in combination with exemestane in postmenopausal women with hormone receptor-positive, human epidermal growth factor receptor 2-negative locally advanced or metastatic breast cancer. In this prespecified exploratory analysis, changes in biomarkers of bone turnover were assessed in patients from baseline to weeks 4, 12, and 24. The serum bone markers assessed were procollagen type 1 N-terminal propeptide (P1NP), C-terminal cross-linking telopeptide of type 1 collagen (CTX), osteocalcin, parathyroid hormone (PTH), and 25-hydroxyvitamin D (25-OH-vitamin D). On-treatment changes in bone markers over time were described per subgroup of interest and efficacy outcomes. Bone marker data were available for 241 of 299 enrolled patients. At the final assessment, P1NP, osteocalcin, PTH, 25-OH-vitamin D (all These exploratory analyses support use of everolimus plus exemestane for the treatment of postmenopausal women with hormone receptor-positive, human epidermal growth factor receptor 2-negative advanced breast cancer, and add to the body of evidence suggesting a potentially favorable impact of everolimus on bone turnover. NCT01626222.

Sections du résumé

BACKGROUND BACKGROUND
Breast cancer and its treatments are associated with a detrimental effect on bone health. Here we report the results of an exploratory analysis assessing changes in levels of biomarkers of bone metabolism in patients enrolled in the phase IIIb 4EVER study.
METHODS METHODS
The 4EVER trial investigated everolimus in combination with exemestane in postmenopausal women with hormone receptor-positive, human epidermal growth factor receptor 2-negative locally advanced or metastatic breast cancer. In this prespecified exploratory analysis, changes in biomarkers of bone turnover were assessed in patients from baseline to weeks 4, 12, and 24. The serum bone markers assessed were procollagen type 1 N-terminal propeptide (P1NP), C-terminal cross-linking telopeptide of type 1 collagen (CTX), osteocalcin, parathyroid hormone (PTH), and 25-hydroxyvitamin D (25-OH-vitamin D). On-treatment changes in bone markers over time were described per subgroup of interest and efficacy outcomes.
RESULTS RESULTS
Bone marker data were available for 241 of 299 enrolled patients. At the final assessment, P1NP, osteocalcin, PTH, 25-OH-vitamin D (all
CONCLUSIONS CONCLUSIONS
These exploratory analyses support use of everolimus plus exemestane for the treatment of postmenopausal women with hormone receptor-positive, human epidermal growth factor receptor 2-negative advanced breast cancer, and add to the body of evidence suggesting a potentially favorable impact of everolimus on bone turnover.
TRIAL REGISTRATION BACKGROUND
NCT01626222.

Identifiants

pubmed: 30515367
doi: 10.1016/j.jbo.2018.09.010
pii: S2212-1374(18)30113-1
pii: 100199
pmc: PMC6263089
doi:

Banques de données

ClinicalTrials.gov
['NCT01626222']

Types de publication

Journal Article

Langues

eng

Pagination

010-10

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Auteurs

Peyman Hadji (P)

Department of Bone Oncology, Endocrinology and Reproductive Medicine, North West Hospital, Steinbacher Hohl 2-26, 60488 Frankfurt am Main, Germany.
Philipps University of Marburg, Steinbacher Hohl 2-26, 60488 Marburg Frankfurt, Germany.

Oliver Stoetzer (O)

Haematology and Oncology, Outpatient Cancer Care Center, Munich, Germany.

Thomas Decker (T)

Oncology Ravensburg, Ravensburg, Germany.

Christian M Kurbacher (CM)

Gynecologic Center Bonn-Friedensplatz, Bonn, Germany.

Frederik Marmé (F)

Department of Obstetrics and Gynecology, University Hospital Heidelberg, Heidelberg, Germany.

Andreas Schneeweiss (A)

National Center for Tumor Diseases, Heidelberg, Germany.

Christoph Mundhenke (C)

Department of Obstetrics and Gynecology, University Hospital Kiel, Kiel, Germany.

Andrea Distelrath (A)

Praxisgemeinschaft für Onkologie und Urologie, Facharztzentrum am Meer, Friedrich-Paffrath-Str. 98, 26389 Wilhelmshaven, Germany.

Peter A Fasching (PA)

Department of Obstetrics and Gynaecology, University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany.

Michael P Lux (MP)

Department of Obstetrics and Gynaecology, University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany.

Diana Lüftner (D)

Medical Department for Haematology, Oncology, and Tumor Immunology, Charité Campus Benjamin Franklin, Berlin, Germany.

Wolfgang Janni (W)

Department of Gynecology and Obstetrics, University Hospital Ulm, Ulm, Germany.

Mathias Muth (M)

Novartis Pharma GmbH, Nuremberg, Germany.

Julia Kreuzeder (J)

Novartis Pharma GmbH, Nuremberg, Germany.

Claudia Quiering (C)

Novartis Pharma GmbH, Nuremberg, Germany.

Eva-Marie Grischke (EM)

Department of Obstetrics and Gynecology, University of Tuebingen, Germany.

Hans Tesch (H)

Department of Oncology, Bethanien Hospital, Frankfurt am Main, Germany.

Classifications MeSH