Denosumab for bone health in prostate and breast cancer patients receiving endocrine therapy? A systematic review and a meta-analysis of randomized trials

Antonio Russo, Lorena Incorvaia, Antonio Galvano, Giuseppe Badalamenti, Viviana Bazan, Giulia Letizia Mauro, Dalila Scaturro, Mario Latteri, Stefania Gori, Fiorella Guadagni, Mario Roselli, Daniele Santini, Daniele Santini, Luisa Castellana, Sofia Cutaia, Stefania Cusenza

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Hormonal therapies for receptor positive-breast and prostate cancer patients have shown clinical efficacy but also several side effects including osteoporosis, loss of bone mass and increased fracture risk. Denosumab represents an anti RANKL (receptor activator of nuclear factor-kB ligand) monoclonal anti-body acting as inhibitor of osteoclasts formation, function, and survival, then increasing bone mass. Herein, we performed a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the role of Denosumab in saving bone health in prostate and breast cancer patients receiving respectively androgen deprivation therapy and adjuvant endocrine therapy. Moreover, selected patients have to be treated with Denosumab at the dose of 60 mg every six month or placebo. Outcomes studied included the bone mass density (BMD) increase at 24 and 36 months, BMD loss, reduction of fractures risk (in particular vertebral) at 24 and 36 months and safety (overall, serious adverse events - SAEs and discontinuation rate). Our results showed a reduction of the BMD loss up to 36 months both at the lumbar and femoral level and a BMD increase both at 24 and 36 months. It was also found a reduction in the number of new vertebral and femoral fractures at 24 and 36 months. Finally, our pooled analysis showed that Denosumab did not affect both the SAEs and therapy discontinuation risk. In conclusion, Denosumab administration can be considered effective and safe in the prevention and management of the above mentioned adverse events related to hormonal therapies designed for breast and prostate tumors.
Original languageEnglish
Number of pages7
JournalJournal of Bone Oncology
Volume18
Publication statusPublished - 2019

Fingerprint

Meta-Analysis
Prostatic Neoplasms
Bone Density
Breast Neoplasms
Bone and Bones
Health
Therapeutics
Fracture Fixation
Femoral Fractures
Osteoclasts
Risk Reduction Behavior
Cytoplasmic and Nuclear Receptors
Thigh
Androgens
Osteoporosis
Prostate
Randomized Controlled Trials
Placebos
Denosumab
Ligands

All Science Journal Classification (ASJC) codes

  • Oncology

Cite this

Denosumab for bone health in prostate and breast cancer patients receiving endocrine therapy? A systematic review and a meta-analysis of randomized trials. / Russo, Antonio; Incorvaia, Lorena; Galvano, Antonio; Badalamenti, Giuseppe; Bazan, Viviana; Letizia Mauro, Giulia; Scaturro, Dalila; Latteri, Mario; Gori, Stefania; Guadagni, Fiorella; Roselli, Mario; Santini, Daniele; Santini, Daniele; Castellana, Luisa; Cutaia, Sofia; Cusenza, Stefania.

In: Journal of Bone Oncology, Vol. 18, 2019.

Research output: Contribution to journalArticle

@article{3e1cdcb1b89c416287ed98a2eb1b1b90,
title = "Denosumab for bone health in prostate and breast cancer patients receiving endocrine therapy? A systematic review and a meta-analysis of randomized trials",
abstract = "Hormonal therapies for receptor positive-breast and prostate cancer patients have shown clinical efficacy but also several side effects including osteoporosis, loss of bone mass and increased fracture risk. Denosumab represents an anti RANKL (receptor activator of nuclear factor-kB ligand) monoclonal anti-body acting as inhibitor of osteoclasts formation, function, and survival, then increasing bone mass. Herein, we performed a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the role of Denosumab in saving bone health in prostate and breast cancer patients receiving respectively androgen deprivation therapy and adjuvant endocrine therapy. Moreover, selected patients have to be treated with Denosumab at the dose of 60 mg every six month or placebo. Outcomes studied included the bone mass density (BMD) increase at 24 and 36 months, BMD loss, reduction of fractures risk (in particular vertebral) at 24 and 36 months and safety (overall, serious adverse events - SAEs and discontinuation rate). Our results showed a reduction of the BMD loss up to 36 months both at the lumbar and femoral level and a BMD increase both at 24 and 36 months. It was also found a reduction in the number of new vertebral and femoral fractures at 24 and 36 months. Finally, our pooled analysis showed that Denosumab did not affect both the SAEs and therapy discontinuation risk. In conclusion, Denosumab administration can be considered effective and safe in the prevention and management of the above mentioned adverse events related to hormonal therapies designed for breast and prostate tumors.",
author = "Antonio Russo and Lorena Incorvaia and Antonio Galvano and Giuseppe Badalamenti and Viviana Bazan and {Letizia Mauro}, Giulia and Dalila Scaturro and Mario Latteri and Stefania Gori and Fiorella Guadagni and Mario Roselli and Daniele Santini and Daniele Santini and Luisa Castellana and Sofia Cutaia and Stefania Cusenza",
year = "2019",
language = "English",
volume = "18",
journal = "Journal of Bone Oncology",
issn = "2212-1374",
publisher = "Elsevier GmbH",

}

TY - JOUR

T1 - Denosumab for bone health in prostate and breast cancer patients receiving endocrine therapy? A systematic review and a meta-analysis of randomized trials

AU - Russo, Antonio

AU - Incorvaia, Lorena

AU - Galvano, Antonio

AU - Badalamenti, Giuseppe

AU - Bazan, Viviana

AU - Letizia Mauro, Giulia

AU - Scaturro, Dalila

AU - Latteri, Mario

AU - Gori, Stefania

AU - Guadagni, Fiorella

AU - Roselli, Mario

AU - Santini, Daniele

AU - Santini, Daniele

AU - Castellana, Luisa

AU - Cutaia, Sofia

AU - Cusenza, Stefania

PY - 2019

Y1 - 2019

N2 - Hormonal therapies for receptor positive-breast and prostate cancer patients have shown clinical efficacy but also several side effects including osteoporosis, loss of bone mass and increased fracture risk. Denosumab represents an anti RANKL (receptor activator of nuclear factor-kB ligand) monoclonal anti-body acting as inhibitor of osteoclasts formation, function, and survival, then increasing bone mass. Herein, we performed a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the role of Denosumab in saving bone health in prostate and breast cancer patients receiving respectively androgen deprivation therapy and adjuvant endocrine therapy. Moreover, selected patients have to be treated with Denosumab at the dose of 60 mg every six month or placebo. Outcomes studied included the bone mass density (BMD) increase at 24 and 36 months, BMD loss, reduction of fractures risk (in particular vertebral) at 24 and 36 months and safety (overall, serious adverse events - SAEs and discontinuation rate). Our results showed a reduction of the BMD loss up to 36 months both at the lumbar and femoral level and a BMD increase both at 24 and 36 months. It was also found a reduction in the number of new vertebral and femoral fractures at 24 and 36 months. Finally, our pooled analysis showed that Denosumab did not affect both the SAEs and therapy discontinuation risk. In conclusion, Denosumab administration can be considered effective and safe in the prevention and management of the above mentioned adverse events related to hormonal therapies designed for breast and prostate tumors.

AB - Hormonal therapies for receptor positive-breast and prostate cancer patients have shown clinical efficacy but also several side effects including osteoporosis, loss of bone mass and increased fracture risk. Denosumab represents an anti RANKL (receptor activator of nuclear factor-kB ligand) monoclonal anti-body acting as inhibitor of osteoclasts formation, function, and survival, then increasing bone mass. Herein, we performed a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the role of Denosumab in saving bone health in prostate and breast cancer patients receiving respectively androgen deprivation therapy and adjuvant endocrine therapy. Moreover, selected patients have to be treated with Denosumab at the dose of 60 mg every six month or placebo. Outcomes studied included the bone mass density (BMD) increase at 24 and 36 months, BMD loss, reduction of fractures risk (in particular vertebral) at 24 and 36 months and safety (overall, serious adverse events - SAEs and discontinuation rate). Our results showed a reduction of the BMD loss up to 36 months both at the lumbar and femoral level and a BMD increase both at 24 and 36 months. It was also found a reduction in the number of new vertebral and femoral fractures at 24 and 36 months. Finally, our pooled analysis showed that Denosumab did not affect both the SAEs and therapy discontinuation risk. In conclusion, Denosumab administration can be considered effective and safe in the prevention and management of the above mentioned adverse events related to hormonal therapies designed for breast and prostate tumors.

UR - http://hdl.handle.net/10447/371526

M3 - Article

VL - 18

JO - Journal of Bone Oncology

JF - Journal of Bone Oncology

SN - 2212-1374

ER -