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Bisphosphonates and denosumab

BCC 2019

At the St. Gallen Conference 2017, the panel was inconclusive about the use of bisphosphonates during adjuvant endocrine therapy to improve disease-free survival – irrespectively of bone mineral density – in premenopausal patients on ovarian function suppression therapy (plus tamoxifen or aromatase inhibitor) (53% yes, 37% no, 10% abstain). Now, 2 years later, there was still no consensus; the panellists voted in exactly the same way. However, the support for the use of bisphosphonates during endocrine therapy to improve disease-free survival in postmenopausal patients has increased: 2 years ago, 76% of the panellists endorsed the use of bisphosphonates for these patients while this year 84% of the panellists was in favour of the therapy. Remarkably, when asked whether the panellists prescribe bisphosphonates in their own daily practice, like they just recommended, only 43% of the panellists voted for “yes” (40% voted “no”, 17% abstained). The opinion of the panellists on the use of denosumab (60 mg twice a year) instead of bisphosphonates was crystal clear, however: 75% of the panellists were not in favour of the use of denosumab, echoing the results of the recently presented data of the D-CARE trial [1].

  1. Coleman RE, et al. J Clin Oncol 2018; 36 (supp) abstract 105.

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