Journal of Clinical Oncology, 2004 ASCO Annual Meeting Proceedings (Post-Meeting Edition).
Vol 22, No 14S (July 15 Supplement), 2004: 529
© 2004 American Society of Clinical Oncology

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Abstract

Adjuvant clodronate treatment improves the overall survival of primary breast cancer patients with micrometastases to bone marrow - a longtime follow-up

CGG-Clinic, Mannheim, Germany; University of Heidelberg, Heidelberg, Germany; University of Tuebingen, Tuebingen, Germany; Markus Krankenhaus, Frankfurt, Germany

529

Background: The detection of micrometastases in bone marrow (BM) of primary breast cancer (BC) patients is an important independent prognostic factor. The presence of these cells goes along with a worse prognosis. However up to now only a few oncological centers take any therapeutical consequence from this diagnostical procedure since it was shown that even cytostatic therapies only have a limited impact on the overall survival of these patients. However we have reported previously that a postoperative treatment with clodronate led to an improvement of disease-free- and overall-survival in comparison to not treated primary BC patients with detected micrometastasis in BM (Diel et al, N Engl J Med 1997). Patients: 150 patients were treated with clodronate p.o. over a minimum of one year, 150 were not treated (9 dropouts). The stage and adjuvant therapy of the disease was not significant different between both groups. The follow up after five years showed a reduced incidence of osseous and visceral metastases in the clodronate-treated group which led to a significant better disease-free- as well as overall survival (p<0.001). These data were confirmed by a large randomised study of Powles et al. Results: This re-analysis has a follow up time of 103±12 months. We were able to reevaluate 290 of the original 309 patients. Incidence of osseous and visceral metastases is similar in both groups. Although we are not able to see a significant advantage regarding the disease-free survival any more there is still a significant better overall-survival for the clodronate-treated group (p<0.01) since 39% of the not-treated group died due to the cancer disease. Conclusion: Adjuvant clodronate therapy prolongs breast cancer patients' survival. The time period of treatment should be evaluated in further studies.

No significant financial relationships to disclose.

Abstract presentation from the 2004 ASCO Annual Meeting