Use of aromatase inhibitors and bisphosphonates as an anticancer therapy in postmenopausal breast cancer

Abstract

Breast cancer is a major cause of morbidity and mortality in postmenopausal women worldwide. Reducing the risk of distant disease recurrence is a primary goal of adjuvant endocrine therapy. As we await data from ongoing Phase III comparison trials, an emerging body of evidence demonstrates important differences between third-generation aromatase inhibitors, particularly with respect to potency and prevention of early distant metastases. Furthermore, a growing body of evidence demonstrates anticancer benefits of bisphosphonates in adjuvant breast cancer and other settings. This article outlines the proceedings from an Expert Panel meeting of regionally diverse breast cancer specialists regarding the appropriate use of aromatase inhibitors in postmenopausal hormone-responsive early breast cancer and bisphosphonates as anticancer therapy in adjuvant breast cancer.

Keywords::

• anticancer
• aromatase inhibitors
• bisphosphonates
• breast cancer
• distant metastases

Acknowledgements

The authors thank Karen Ventii for her medical editorial assistance with this article.

Financial & competing interests disclosure

Henning T Mouridsen has disclosed that he has served as a consultant for and received honoraria from Novartis. Andre Robidoux has disclosed that he has served as a consultant for and received honoraria from Novartis. Beat Thürlimann has disclosed that he has received honoraria and travel grants for educational activities from Novartis, AstraZeneca and Pfizer. Beat Thürlimann has also disclosed that he currently holds Novartis stock and that his institution has received financial support for patient support programs from AstraZeneca. Joseph Gligorov has disclosed that he has served as a consultant for and received honoraria from Novartis. Per Lønning has disclosed that he has received honoraria and financial compensation for participating in advisory boards and speaking engagements for Novartis, Pfizer and AstraZeneca. Julie Doughty has disclosed that she has received speaker fees from Novartis, Roche and Pfizer, research funding from AstraZeneca and Roche, and honoraria from Roche and Novartis. Michael Gnant has disclosed that he has served as a consultant for, is on advisory boards for, and received honoraria and research funding from AstraZeneca, Novartis and Roche, and has also received research funding and honoraria from sanofi-aventis, and served as a consultant for, is on advisory boards for and received honoraria from Pfizer. Kimberly Blackwell has disclosed that she has received speaker fees from Novartis. Expert Panel members were free to express their views. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Financial support for medical editorial assistance was provided by Novartis.

Notes

AC: Doxorubicin + cyclophosphamide; CMF: Cyclophosphamide + methotrexate + fluorouracil; E2: Estradiol; FSH: Follicle-stimulating hormone; HRT: Hormone-replacement therapy; LH: Luteinizing hormone; PM: Postmenopausal.

Adapted with permission from [51].