Phase 2 placebo-controlled, single-blind trial to evaluate the impact of oral ibandronate on bone mineral density in osteopenic breast cancer patients receiving adjuvant aromatase inhibitors: 5-year results of the single-centre BONADIUV trial

Eur J Cancer. 2019 Feb:108:100-110. doi: 10.1016/j.ejca.2018.12.005. Epub 2019 Jan 14.

Abstract

Aim: We present the final results of the BONADIUV trial, a single-blind, randomised, placebo-controlled phase 2 study to evaluate the impact of ibandronate treatment on bone mineral density (BMD) in osteopenic women taking aromatase inhibitors (AI).

Patients and methods: Between 2011 and 2014, 171 osteopenic patients were randomised in a 1:1 ratio to receive either placebo or oral monthly ibandronate (150 mg). Treatment duration was 2 years, with 6-month evaluation. Primary end-point was the 2-year lumbar spine (LS) and total hip (TH) T-score mean differences as measure of BMD variation. Secondary analyses of survival outcomes have been performed at a 5-year median follow-up. CLINICALTRIALS.

Gov identifier: NCT02616744.

Results: Median age of study population was 60.2 years (range 44-75). At the database cut-off time, the median follow-up was 63.3 months (range 2.7-87.3). No difference in terms of T-score was shown at baseline between arms both for TH (P = 0.61) and LS (P = 0.96). At 2-year follow up, the mean change was statistically significant in favour of ibandronate arm both at TH (P = 0.0002) and LS (P < 0.0001). No significant difference in terms of adverse events was observed between arms. At a median follow-up of 63.3 months (range 2.7-87.3), the overall survival (OS) rate was 97.5% in the placebo group and 93.0% in the ibandronate arm (P = 0.19). The invasive disease-free survival (iDFS) rates did not differ between groups (P = 0.42).

Conclusions: Ibandronate compared to placebo improved BMD change in osteopenic women treated with adjuvant AI. Five-year survival analyses showed no difference between arms in terms of OS and iDFS rates.

Keywords: Bisphosphonates; Bone loss; Breast cancer; Endocrine therapy; Ibandronate; Phase 2; Randomised trial; Survival.

Publication types

  • Clinical Trial, Phase II
  • Randomized Controlled Trial

MeSH terms

  • Absorptiometry, Photon
  • Adult
  • Aged
  • Anastrozole / therapeutic use
  • Androstadienes / therapeutic use
  • Aromatase Inhibitors / therapeutic use*
  • Bone Density
  • Bone Density Conservation Agents / therapeutic use*
  • Bone Diseases, Metabolic / complications
  • Bone Diseases, Metabolic / diagnostic imaging
  • Bone Diseases, Metabolic / drug therapy*
  • Breast Neoplasms / complications
  • Breast Neoplasms / drug therapy*
  • Chemotherapy, Adjuvant
  • Female
  • Humans
  • Ibandronic Acid / therapeutic use*
  • Letrozole / therapeutic use
  • Middle Aged
  • Single-Blind Method

Substances

  • Androstadienes
  • Aromatase Inhibitors
  • Bone Density Conservation Agents
  • Anastrozole
  • Letrozole
  • exemestane
  • Ibandronic Acid

Associated data

  • ClinicalTrials.gov/NCT02616744