Report in English with a Dutch summary (KCE reports 63A)

KCE reports 63 Breast Cancer 113
Treatment of bone metastases.
Study ID Ref Search
date
Bisphosphonates
Pavlakis N et al [110] 2004 Women with
metastatic
breast cancer
Wardley A 2005 [250] NA Histologically
confirmed
diagnosis of
breast cancer
and ≥1 bone
M+
Population Intervention Ouctomes Results Comments Study
type
Bisphosphonates In 9 studies (2189 women with advanced
breast cancer and existing
bonemetastases), BP reduced the risk of
developing a skeletal event by 17% (RR
0.83; 95%CI 0.78 to 0.89; P <
0.00001). The BP most effective in
reducing the risk of developing a skeletal
event by 41% was 4 mg IV zolendronate
(RR 0.59, 95%CI 0.42-0.82). Women with
advanced breast cancer and clinically
evident bone M+ treated with BP showed
significant delays in the median time to a
skeletal event. Compared with placebo or
no BP, with BP significant improvements in
bone pain were reported in seven studies.
Improvements in global quality of life were
reported in only the three studies of iv and
oral ibandronate.
Treatment with BP does not appear to
affect survival in women with advanced
Zoledronic acid in community
setting (n = 56) vs. hospital
setting (n = 45)
breast cancer.
Significantly greater improvements in pain
scores after treatment in the community
setting compared with the hospital
crossover setting for worst pain (P=0.021),
average pain (P=0.003), and interference
with general activity (P=0.001).
21 RCTs included (18
RCTs involved women
with bone M+)
SR High
RCT High
Level of
evidence