Freedman Orit C, Amir Eitan, Clemons Mark J
Division of Medical Oncology, Princess Margaret Hospital, Toronto, Ontario, Canada.
Crit Rev Oncol Hematol. 2009 Oct;72(1):56-64. doi: 10.1016/j.critrevonc.2009.03.001. Epub 2009 Mar 23.
Bone is the most common site of metastatic spread in breast cancer patients. The use of bisphosphonates (BPs) in women with bone metastases from breast cancer has been shown to reduce the incidence, and delay the onset of, skeletal-related events. Indeed, BPs are now an established standard of care in treating patients with bone metastases. As with many new therapies, once efficacy in the metastatic setting is demonstrated, therapies are tested in the adjuvant setting. There are a number of trials that have tested the hypothesis that BP therapy in women with early breast cancer may not only reduce the development of skeletal metastases but also improve both disease-free and overall survival; recent randomized trials have demonstrated intriguing results regarding the possible anticancer effects of adjuvant BP therapy. Furthermore, interesting signals are filtering through from trials evaluating the role of BPs to prevent cancer-treatment induced bone loss. Many of these trials will be reported in the near future. In this article we review possible subgroups that may benefit from adjuvant treatment with BPs, and ongoing trials that may offer more definitive answers.
骨是乳腺癌患者转移扩散最常见的部位。已证明，在患有乳腺癌骨转移的女性中使用双膦酸盐（BP）可降低骨骼相关事件的发生率，并延迟其发生。事实上，BP目前是治疗骨转移患者的既定标准治疗方法。与许多新疗法一样，一旦在转移环境中的疗效得到证实，就会在辅助治疗环境中对疗法进行测试。有多项试验检验了这样的假设，即早期乳腺癌女性接受BP治疗不仅可以减少骨转移的发生，还可以改善无病生存期和总生存期；近期的随机试验已就辅助BP治疗可能的抗癌作用得出了有趣的结果。此外，评估BP预防癌症治疗引起的骨质流失作用的试验也传来了有趣的信号。这些试验中的许多将在不久的将来公布。在本文中，我们回顾了可能从BP辅助治疗中获益得亚组，以及可能提供更明确答案的正在进行的试验。
