Catherine Van Poznak, MD, FASCO
AS REPORTED BY Catherine Van Poznak, MD, FASCO, of the University of Michigan, Ann Arbor, and colleagues in the Journal of Clinical Oncology, ASCO and Cancer Care Ontario (CCO) have collaborated in providing a focused update for the ASCO clinical practice guideline on the role of bone-modifying agents in metastatic breast cancer.1 A joint update committee conducted a targeted systematic literature review to identify relevant studies; the update was informed by data from three phase III noninferiority trials of dosing intervals, one systematic review and meta-analysis of studies of de-escalation of bone-modifying agents, and two randomized trials of bone-modifying agents in control of pain secondary to bone metastases. The update committee was co-chaired by Dr. Van Poznak and Beverly Moy, MD, FASCO, of Massachusetts General Hospital.
Beverly Moy, MD, FASCO
Updated recommendations and recommendations unchanged from the 2011 guideline are reproduced/summarized here. For updated recommendations, the type of recommendation, evidence quality, and strength of recommendation are shown in brackets.
PATIENTS WITH BREAST CANCER who have evidence of bone metastases should be treated with bone-modifying agents. Options include denosumab (Xgeva) at 120 mg subcutaneously every 4 weeks; pamidronate at 90 mg intravenously (IV) every 3 to 4 weeks; or zoledronate at 4 mg IV every 12 weeks or every 3 to 4 weeks.
2017 Guideline Updates
Recommendation Updated for 2017 Guideline
Recommendations Unchanged From 2011 Guideline Update
Additional information is available at www.asco.org/breast-cancer-guidelines and www.asco.org/guidelineswiki. ■
DISCLOSURE: For full disclosures of the study authors, visit www.jco.ascopubs.org.
1. Van Poznak C, Somerfield MR, Barlow WE, et al: Role of bone-modifying agents in metastatic breast cancer: An American Society of Clinical Oncology–Cancer Care Ontario focused guideline update. J Clin Oncol 35:3978- 3986, 2017.
Julie R. Gralow, MD, FASCO
AS REVIEWED in this issue of The ASCO Post, ASCO and Cancer Care Ontario (CCO) have issued an updated guideline on the role of bone-modifying agents in metastatic breast cancer.1 The updated guideline supports a change in clinical practice for our patients with...