Perceptions around bone-modifying agent use in patients with bone metastases from breast and castration resistant prostate cancer: a patient survey.
Bone metastases
Bone modifying agents
Journal
Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
ISSN: 1433-7339
Titre abrégé: Support Care Cancer
Pays: Germany
ID NLM: 9302957
Informations de publication
Date de publication:
Nov 2021
Nov 2021
Historique:
received:
28
12
2020
accepted:
19
04
2021
pubmed:
24
5
2021
medline:
16
10
2021
entrez:
23
5
2021
Statut:
ppublish
Résumé
Optimal use of bone-modifying agent (BMA) therapy in patients with bone metastases from breast and castrate-resistant prostate cancer (CRPC) is evolving. Patients receiving BMA for bone metastases from breast or CRPC were surveyed. Information was collected on patient and disease characteristics, BMA treatments and perceptions regarding BMA benefits and side effects. Interest in participation in trials of de-escalated BMA therapy was also gauged. Of 220 patients contacted, 172 eligible patients responded (response rate 78%). Median age was 67 (range: 21-91); 137 (80%) had breast cancer and 35 (20%) CRPC. Symptomatic skeletal events (SSEs) occurred prior to starting BMAs in 61% (84/137) of breast and 48% (17/35) of CRPC patients. Among breast cancer patients, 47, 33 and 13% received zoledronate, pamidronate and denosumab, respectively. Eighty-five percent (30/35) of CRPC patients received denosumab. De-escalation of therapy was more common among breast cancer patients. Although most patients correctly reported the goals of BMA therapy were to "help stop fractures" (62%) and "[improve] quality of life" (63%), 46.5% felt it prolonged survival and 54% felt it reduced bone progression. Most respondents (102/129, 79%) were comfortable with de-escalating to 6-monthly treatment after 2 years of BMA therapy. Patients considered the most important endpoints of de-escalation studies to be "stability of bone metastases" (45%), "quality of life" (22%) and "SSE rates" (14%). Twelve weekly BMA was more common in breast than in prostate cancer. There remain misconceptions about the benefits of BMAs, highlighting potential gaps in patient education. Patients were interested in further BMA de-escalation after 2 years of prior BMA and provided study endpoints that were most important to them.
Sections du résumé
BACKGROUND
BACKGROUND
Optimal use of bone-modifying agent (BMA) therapy in patients with bone metastases from breast and castrate-resistant prostate cancer (CRPC) is evolving.
METHODS
METHODS
Patients receiving BMA for bone metastases from breast or CRPC were surveyed. Information was collected on patient and disease characteristics, BMA treatments and perceptions regarding BMA benefits and side effects. Interest in participation in trials of de-escalated BMA therapy was also gauged.
RESULTS
RESULTS
Of 220 patients contacted, 172 eligible patients responded (response rate 78%). Median age was 67 (range: 21-91); 137 (80%) had breast cancer and 35 (20%) CRPC. Symptomatic skeletal events (SSEs) occurred prior to starting BMAs in 61% (84/137) of breast and 48% (17/35) of CRPC patients. Among breast cancer patients, 47, 33 and 13% received zoledronate, pamidronate and denosumab, respectively. Eighty-five percent (30/35) of CRPC patients received denosumab. De-escalation of therapy was more common among breast cancer patients. Although most patients correctly reported the goals of BMA therapy were to "help stop fractures" (62%) and "[improve] quality of life" (63%), 46.5% felt it prolonged survival and 54% felt it reduced bone progression. Most respondents (102/129, 79%) were comfortable with de-escalating to 6-monthly treatment after 2 years of BMA therapy. Patients considered the most important endpoints of de-escalation studies to be "stability of bone metastases" (45%), "quality of life" (22%) and "SSE rates" (14%).
CONCLUSION
CONCLUSIONS
Twelve weekly BMA was more common in breast than in prostate cancer. There remain misconceptions about the benefits of BMAs, highlighting potential gaps in patient education. Patients were interested in further BMA de-escalation after 2 years of prior BMA and provided study endpoints that were most important to them.
Identifiants
pubmed: 34023950
doi: 10.1007/s00520-021-06238-1
pii: 10.1007/s00520-021-06238-1
pmc: PMC8140584
doi:
Substances chimiques
Bone Density Conservation Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
6903-6912Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
Références
JAMA. 2017 Jan 3;317(1):48-58
pubmed: 28030702
Int J Oral Maxillofac Surg. 2012 Nov;41(11):1397-403
pubmed: 22840716
Support Care Cancer. 2011 Nov;19(11):1687-96
pubmed: 21785900
Support Care Cancer. 2016 Jan;24(1):447-455
pubmed: 26335402
Curr Oncol. 2012 Oct;19(5):259-68
pubmed: 23144574
Curr Med Res Opin. 2012 Jul;28(7):1119-27
pubmed: 22536885
Lancet Oncol. 2014 Jun;15(7):738-46
pubmed: 24836273
J Clin Endocrinol Metab. 2017 Feb 1;102(2):354-358
pubmed: 27732330
J Clin Med. 2013 Aug 19;2(3):67-88
pubmed: 26237063
N Engl J Med. 1996 Dec 12;335(24):1785-91
pubmed: 8965890
Cancer. 1997 Oct 15;80(8 Suppl):1588-94
pubmed: 9362426
Clin Breast Cancer. 2019 Feb;19(1):e40-e47
pubmed: 30318304
BMC Cancer. 2018 Jan 6;18(1):44
pubmed: 29306325
Lancet Oncol. 2013 Jun;14(7):663-70
pubmed: 23684411
Breast J. 2013 Sep-Oct;19(5):504-11
pubmed: 23800050
Oncologist. 2005 Nov-Dec;10(10):842-8
pubmed: 16314295
J Bone Oncol. 2016 Feb 23;5(2):57-62
pubmed: 27335772
J Clin Oncol. 2009 Nov 10;27(32):5356-62
pubmed: 19805682
J Clin Oncol. 2017 Dec 10;35(35):3978-3986
pubmed: 29035643
Future Oncol. 2011 Mar;7(3):381-3
pubmed: 21417901
J Bone Oncol. 2013 Apr 15;2(2):77-83
pubmed: 26909274
Support Care Cancer. 2015 Nov;23(11):3269-75
pubmed: 25933700
JAMA Oncol. 2017 Jul 1;3(7):906-912
pubmed: 28125763
Cancer J. 2001 Sep-Oct;7(5):377-87
pubmed: 11693896
Curr Oncol. 2018 Aug;25(4):e298-e304
pubmed: 30111975
J Bone Oncol. 2013 Jun 21;2(3):105-9
pubmed: 26909279
J Natl Compr Canc Netw. 2020 Apr;18(4):452-478
pubmed: 32259783
Support Care Cancer. 2021 Feb;29(2):925-943
pubmed: 32535678
J Bone Oncol. 2013 Oct 03;2(4):137-44
pubmed: 26909284
Curr Opin Support Palliat Care. 2014 Dec;8(4):420-8
pubmed: 25121618
Br J Cancer. 1987 Jan;55(1):61-6
pubmed: 3814476
J Clin Oncol. 2009 Apr 1;27(10):1564-71
pubmed: 19237632
Eur J Cancer. 2021 Jan;142:132-140
pubmed: 33023785