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2018 ASCO Annual Meeting!


Session: Breast Cancer—Local/Regional/Adjuvant

Type: Poster Session

Time: Saturday June 2, 8:00 AM to 11:30 AM

Location: Hall A

Overall survival in female Medicare beneficiaries with early stage breast cancer receiving bisphosphonates or denosumab.

Sub-category:
Adjuvant Therapy

Category:
Breast Cancer—Local/Regional/Adjuvant

Meeting:
2018 ASCO Annual Meeting

Abstract No:
530

Poster Board Number:
Poster Session (Board #22)

Citation:
J Clin Oncol 36, 2018 (suppl; abstr 530)

Author(s): Raul A Herrera Pena, Xiudong Lei, Mariana Chavez-MacGregor, Hui Zhao, Sharon Hermes Giordano, Maria E. Suarez-Almazor; University of Texas MD Anderson Cancer Center, Houston, TX; The University of Texas MD Anderson Cancer Center, Houston, TX; Health Services Research Department, The University of Texas MD Anderson Cancer Center, Houston, TX; Section of Rheumatology & Clinical Immunology, Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX

Abstract Disclosures

Abstract:

Background: Adjuvant bisphosphonates in early breast cancer (BC) have resulted in reduction in bone metastasis and improved overall survival (OS), particularly in post-menopausal women. We aim to evaluate the effect of bone-modifying agents (BMA) on survival in a population based cohort of older BC patients. Methods: Patients aged ≥ 66 yo diagnosed with stage I-III BC between 2007 and 2013 were identified in SEER-Medicare and TCR-Medicare database. Patients were required to have Medicare Parts A, B and D coverage. Patients receiving at least 6 months of an oral bisphosphonate, two doses of ibandronate or one dose of zoledronate or denosumab at doses equivalent or higher to those approved for osteoporosis, during the first two years of BC diagnosis were identified as having received a BMA. Five year-OS was estimated with Kaplan-Meier with groups compared with the log rank test. Cox proportional hazards models were fitted to determine the association of BMA and OS after propensity score adjustment. Subgroup analysis were stratified by stage. Results: The final cohort included 37,604 patients. Median age was 75 years. 32,045 (85.2%) of the patients had hormone receptor-positive tumors. Overall, 8,591 (22.8%) of the patients were treated with BMA. Of these, 7,349 (85.5%) received bisphosphonates only. The unadjusted 5 year OS was 81% and 77 % for those who did and did not receive BMA, respectively (P < 0.0001). After multivariate analysis including propensity scores adjustment, treatment with BMA was associated with a statistically significant increased survival (Hazard ratio [HR] 0.91, 95% CI = 0.85-0.96). When stratified by stage, BMA vs no BMA showed an improvement in unadjusted 5 year OS in patients with Stage II (5y OS 79% vs 72%, P < 0.0001) and Stage III (64% vs 57%, P = 0.002) but not for Stage I (86% vs 85%, P = 0.88). After multivariate adjustment, survival remained significant for Stage II (HR 0.81, 95% CI = 0.73-0.90) but not for Stage III (HR 0.91, 95% CI = 0.78-1.07). Conclusions: Use of BMA in post-menopausal woman with early stage BC patients was associated with improved 5 year OS. Stage stratified subgroup analysis showed that the difference in survival was significant only for patients with stage II.

 
Other Abstracts in this Sub-Category:

 

1. TAILORx: Phase III trial of chemoendocrine therapy versus endocrine therapy alone in hormone receptor-positive, HER2-negative, node-negative breast cancer and an intermediate prognosis 21-gene recurrence score.

Meeting: 2018 ASCO Annual Meeting Abstract No: LBA1 First Author: Joseph A. Sparano
Category: Breast Cancer—Local/Regional/Adjuvant - Adjuvant Therapy

 

2. Adjuvant denosumab in early breast cancer: Disease-free survival analysis of 3,425 postmenopausal patients in the ABCSG-18 trial.

Meeting: 2018 ASCO Annual Meeting Abstract No: 500 First Author: Michael Gnant
Category: Breast Cancer—Local/Regional/Adjuvant - Adjuvant Therapy

 

3. Adjuvant denosumab in early breast cancer: First results from the international multicenter randomized phase III placebo controlled D-CARE study.

Meeting: 2018 ASCO Annual Meeting Abstract No: 501 First Author: Robert E. Coleman
Category: Breast Cancer—Local/Regional/Adjuvant - Adjuvant Therapy

 

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