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Treatment for bone metastases?

Page last modified on: October 10, 2008
Question from Dolphin: If you have metastases to bone at age 26, first diagnosed at age 24 and carry both genes and first treatment did not work, will there be any new hope for metastases to bone at such a young age?
Answers —Andrew Seidman, M.D.: I would first comment that certainly breast cancer in patients under the age of 30 represents a very small percentage of all breast cancers. Undoubtedly, there are unique aspects to the biology of breast cancer in younger women. In general, the principles that we apply in selecting treatment for a 36-year-old premenopausal woman are the same that we would apply for a 26-year-old woman. Here I refer to the use of anti-estrogen treatment when indicated, based on estrogen receptor and progesterone receptor status, the use of Herceptin when indicated based on HER2 status, and the use of chemotherapy in general. With respect to bone specific management, the use of bisphosphonates such as zoledronate, also known as Zometa, can often be helpful in reducing skeletal complications of metastatic breast cancer such as bone pain, fracture, and a high calcium level in the bloodstream or hypercalcemia. At the ASCO meeting this spring, we heard about a new promising bone targeted agent called Denosumab, also known as AMG 162, which is a monoclonal antibody that inhibits the activity of a molecule called RANKL, which ultimately shuts off the process of bone destruction that can occur when breast cancer travels to bones. Dr. Alan Lipton presented some preliminary data, and a recent report in the New England Journal of Medicine suggests that this agent may play an important future role, either in addition to or instead of existing bone targeted drugs.
Jennifer Armstrong, M.D.: There is absolutely hope. While the tumor you described sounds quite aggressive, there are many treatments currently available and as Dr. Seidman has so impressively detailed, more coming out. You should have every reason to expect that the quality of your life can be improved. Hang in there.

On Wednesday, July 19, 2006, our Ask-the-Expert Online Conference was called Targeted Therapies: What is Right for You?Andrew Seidman, M.D. and moderator Jennifer Armstrong, M.D. answered your questions about different kinds of targeted therapies and how they work.

The materials presented in these conferences do not necessarily reflect the views of breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.

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Meet the Experts

Andrew D. Seidman, M.D.Andrew D. Seidman, M.D. is an attending physician for the Breast Cancer Medicine Service, Memorial Sloan-Kettering Cancer Center, New York, and a professor of medicine, Joan and Sanford I. Weill Medical College of Cornell University.

Jennifer Armstrong, M.D.Jennifer Armstrong, M.D. is a breast cancer oncologist at Paoli Hematology-Oncology Associates in Paoli, Pa., with a special interest in physicians' communication skills.

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