Effect of denosumab on bone mineral density in women receiving adjuvant aromatase inhibitors for non-metastatic breast cancer: subgroup analyses of a phase 3 study

Breast Cancer Res Treat. 2009 Nov;118(1):81-7. doi: 10.1007/s10549-009-0352-y. Epub 2009 Mar 24.

Abstract

Denosumab increased lumbar spine bone mineral density (BMD) versus placebo in a 2-year, randomized, placebo-controlled, phase 3 study of patients with hormone-receptor-positive, non-metastatic breast cancer and low bone mass who were receiving adjuvant aromatase inhibitor therapy. In subgroup analyses at 12 and 24 months, we evaluated factors (duration and type of aromatase inhibitor, tamoxifen use, age, time since menopause, body mass index, T-score) that might influence BMD at the lumbar spine, total hip, femoral neck, and 1/3 radius. Patients were randomized to receive placebo (n = 125) or 60 mg denosumab (n = 127) subcutaneously every 6 months. In all subgroups, 12 or 24 months' treatment with denosumab was associated with larger BMD gains than placebo across multiple skeletal sites. Most increases were statistically significant (P < 0.05). Twice-yearly administration of denosumab, regardless of patient subgroup or skeletal site, resulted in consistent increases in BMD versus placebo at 12 and 24 months.

Trial registration: ClinicalTrials.gov NCT00089661.

Publication types

  • Clinical Trial, Phase III
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Absorptiometry, Photon
  • Aged
  • Antibodies, Monoclonal / administration & dosage
  • Antibodies, Monoclonal / therapeutic use*
  • Antibodies, Monoclonal, Humanized
  • Antineoplastic Agents, Hormonal / adverse effects
  • Antineoplastic Agents, Hormonal / therapeutic use
  • Aromatase Inhibitors / adverse effects*
  • Aromatase Inhibitors / therapeutic use
  • Bone Density / drug effects*
  • Breast Neoplasms / complications
  • Breast Neoplasms / drug therapy*
  • Chemotherapy, Adjuvant*
  • Combined Modality Therapy
  • Denosumab
  • Drug Administration Schedule
  • Estrogens*
  • Female
  • Femur Neck / diagnostic imaging
  • Femur Neck / drug effects
  • Humans
  • Lumbar Vertebrae / diagnostic imaging
  • Lumbar Vertebrae / drug effects
  • Middle Aged
  • Neoplasms, Hormone-Dependent / complications
  • Neoplasms, Hormone-Dependent / drug therapy*
  • Osteoporosis, Postmenopausal / chemically induced
  • Osteoporosis, Postmenopausal / drug therapy*
  • RANK Ligand / administration & dosage
  • RANK Ligand / antagonists & inhibitors
  • RANK Ligand / immunology
  • RANK Ligand / therapeutic use*
  • Tamoxifen / adverse effects
  • Tamoxifen / therapeutic use

Substances

  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Antineoplastic Agents, Hormonal
  • Aromatase Inhibitors
  • Estrogens
  • RANK Ligand
  • TNFSF11 protein, human
  • Tamoxifen
  • Denosumab

Associated data

  • ClinicalTrials.gov/NCT00089661