Skip to main content
British Journal of Cancer logoLink to British Journal of Cancer
. 1997;75(4):602–605. doi: 10.1038/bjc.1997.105

Clodronate improves bone mineral density in post-menopausal breast cancer patients treated with adjuvant antioestrogens.

T Saarto 1, C Blomqvist 1, M Välimäki 1, P Mäkelä 1, S Sarna 1, I Elomaa 1
PMCID: PMC2063321  PMID: 9052418

Abstract

The effect of clodronate on bone mineral density (BMD) was studied in 121 post-menopausal breast cancer women without skeletal metastases. In addition, two antioestrogens, tamoxifen and toremifene, were compared in their action on bone mineral density. Patients were randomized to have an adjuvant antioestrogen treatment either 20 mg of tamoxifen or 60 mg of toremifene daily for 3 years. In addition all patients were randomized to have 1600 mg of oral clodronate daily or to act as control subjects. BMD of the lumbar spine and femoral neck were measured by dual-energy radiographic absorptiometry before therapy and at 1 and 2 years. At 2 years, clodronate with antioestrogens markedly increased BMD in the lumbar spine and femoral neck by 2.9% and 3.7% (P = 0.001 and 0.006 respectively). There were no significant changes in BMD in the patients given antioestrogens only. No significant differences were found between tamoxifen and toremifene on bone mineral density. Clodronate with antioestrogens significantly increased bone mass in the lumbar spine and femoral neck. Both antioestrogens, tamoxifen and toremifene, similarly prevented bone loss in the lumbar spine and femoral neck.

Full text

PDF
605

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Chesnut C. H., 3rd Treatment of postmenopausal osteoporosis. Compr Ther. 1984 Jul;10(7):41–47. [PubMed] [Google Scholar]
  2. Ettinger B., Genant H. K., Cann C. E. Postmenopausal bone loss is prevented by treatment with low-dosage estrogen with calcium. Ann Intern Med. 1987 Jan;106(1):40–45. doi: 10.7326/0003-4819-106-1-40. [DOI] [PubMed] [Google Scholar]
  3. Ettinger B., Genant H. K., Steiger P., Madvig P. Low-dosage micronized 17 beta-estradiol prevents bone loss in postmenopausal women. Am J Obstet Gynecol. 1992 Feb;166(2):479–488. doi: 10.1016/0002-9378(92)91653-r. [DOI] [PubMed] [Google Scholar]
  4. Filipponi P., Pedetti M., Fedeli L., Cini L., Palumbo R., Boldrini S., Massoni C., Cristallini S. Cyclical clodronate is effective in preventing postmenopausal bone loss: a comparative study with transcutaneous hormone replacement therapy. J Bone Miner Res. 1995 May;10(5):697–703. doi: 10.1002/jbmr.5650100505. [DOI] [PubMed] [Google Scholar]
  5. Giannini S., D'Angelo A., Malvasi L., Castrignano R., Pati T., Tronca R., Liberto L., Nobile M., Crepaldi G. Effects of one-year cyclical treatment with clodronate on postmenopausal bone loss. Bone. 1993 Mar-Apr;14(2):137–141. doi: 10.1016/8756-3282(93)90240-b. [DOI] [PubMed] [Google Scholar]
  6. Harris S. T., Watts N. B., Jackson R. D., Genant H. K., Wasnich R. D., Ross P., Miller P. D., Licata A. A., Chesnut C. H., 3rd Four-year study of intermittent cyclic etidronate treatment of postmenopausal osteoporosis: three years of blinded therapy followed by one year of open therapy. Am J Med. 1993 Dec;95(6):557–567. doi: 10.1016/0002-9343(93)90350-x. [DOI] [PubMed] [Google Scholar]
  7. Kristensen B., Ejlertsen B., Dalgaard P., Larsen L., Holmegaard S. N., Transbøl I., Mouridsen H. T. Tamoxifen and bone metabolism in postmenopausal low-risk breast cancer patients: a randomized study. J Clin Oncol. 1994 May;12(5):992–997. doi: 10.1200/JCO.1994.12.5.992. [DOI] [PubMed] [Google Scholar]
  8. Liberman U. A., Weiss S. R., Bröll J., Minne H. W., Quan H., Bell N. H., Rodriguez-Portales J., Downs R. W., Jr, Dequeker J., Favus M. Effect of oral alendronate on bone mineral density and the incidence of fractures in postmenopausal osteoporosis. The Alendronate Phase III Osteoporosis Treatment Study Group. N Engl J Med. 1995 Nov 30;333(22):1437–1443. doi: 10.1056/NEJM199511303332201. [DOI] [PubMed] [Google Scholar]
  9. Love R. R., Mazess R. B., Barden H. S., Epstein S., Newcomb P. A., Jordan V. C., Carbone P. P., DeMets D. L. Effects of tamoxifen on bone mineral density in postmenopausal women with breast cancer. N Engl J Med. 1992 Mar 26;326(13):852–856. doi: 10.1056/NEJM199203263261302. [DOI] [PubMed] [Google Scholar]
  10. Martoni A., Guaraldi M., Camera P., Biagi R., Marri S., Beghé F., Pannuti F. Controlled clinical study on the use of dichloromethylene diphosphonate in patients with breast carcinoma metastasizing to the skeleton. Oncology. 1991;48(2):97–101. doi: 10.1159/000226904. [DOI] [PubMed] [Google Scholar]
  11. Paterson A. H., Powles T. J., Kanis J. A., McCloskey E., Hanson J., Ashley S. Double-blind controlled trial of oral clodronate in patients with bone metastases from breast cancer. J Clin Oncol. 1993 Jan;11(1):59–65. doi: 10.1200/JCO.1993.11.1.59. [DOI] [PubMed] [Google Scholar]
  12. Powles T. J., Hickish T., Kanis J. A., Tidy A., Ashley S. Effect of tamoxifen on bone mineral density measured by dual-energy x-ray absorptiometry in healthy premenopausal and postmenopausal women. J Clin Oncol. 1996 Jan;14(1):78–84. doi: 10.1200/JCO.1996.14.1.78. [DOI] [PubMed] [Google Scholar]
  13. Reid I. R., Wattie D. J., Evans M. C., Gamble G. D., Stapleton J. P., Cornish J. Continuous therapy with pamidronate, a potent bisphosphonate, in postmenopausal osteoporosis. J Clin Endocrinol Metab. 1994 Dec;79(6):1595–1599. doi: 10.1210/jcem.79.6.7989461. [DOI] [PubMed] [Google Scholar]
  14. Stevenson J. C., Cust M. P., Gangar K. F., Hillard T. C., Lees B., Whitehead M. I. Effects of transdermal versus oral hormone replacement therapy on bone density in spine and proximal femur in postmenopausal women. Lancet. 1990 Aug 4;336(8710):265–269. doi: 10.1016/0140-6736(90)91801-g. [DOI] [PubMed] [Google Scholar]
  15. Storm T., Thamsborg G., Steiniche T., Genant H. K., Sørensen O. H. Effect of intermittent cyclical etidronate therapy on bone mass and fracture rate in women with postmenopausal osteoporosis. N Engl J Med. 1990 May 3;322(18):1265–1271. doi: 10.1056/NEJM199005033221803. [DOI] [PubMed] [Google Scholar]
  16. Valavaara R., Pyrhönen S., Heikkinen M., Rissanen P., Blanco G., Thölix E., Nordman E., Taskinen P., Holsti L., Hajba A. Toremifene, a new antiestrogenic compound, for treatment of advanced breast cancer. Phase II study. Eur J Cancer Clin Oncol. 1988 Apr;24(4):785–790. doi: 10.1016/0277-5379(88)90316-1. [DOI] [PubMed] [Google Scholar]
  17. Ward R. L., Morgan G., Dalley D., Kelly P. J. Tamoxifen reduces bone turnover and prevents lumbar spine and proximal femoral bone loss in early postmenopausal women. Bone Miner. 1993 Aug;22(2):87–94. doi: 10.1016/s0169-6009(08)80220-6. [DOI] [PubMed] [Google Scholar]
  18. Watts N. B., Harris S. T., Genant H. K., Wasnich R. D., Miller P. D., Jackson R. D., Licata A. A., Ross P., Woodson G. C., 3rd, Yanover M. J. Intermittent cyclical etidronate treatment of postmenopausal osteoporosis. N Engl J Med. 1990 Jul 12;323(2):73–79. doi: 10.1056/NEJM199007123230201. [DOI] [PubMed] [Google Scholar]
  19. di Salle E., Zaccheo T., Ornati G. Antiestrogenic and antitumor properties of the new triphenylethylene derivative toremifene in the rat. J Steroid Biochem. 1990 Jun 22;36(3):203–206. doi: 10.1016/0022-4731(90)90005-d. [DOI] [PubMed] [Google Scholar]
  20. van Holten-Verzantvoort A. T., Kroon H. M., Bijvoet O. L., Cleton F. J., Beex L. V., Blijham G., Hermans J., Neijt J. P., Papapoulos S. E., Sleeboom H. P. Palliative pamidronate treatment in patients with bone metastases from breast cancer. J Clin Oncol. 1993 Mar;11(3):491–498. doi: 10.1200/JCO.1993.11.3.491. [DOI] [PubMed] [Google Scholar]

Articles from British Journal of Cancer are provided here courtesy of Cancer Research UK

RESOURCES