Vienna: With the largest breast cancer study conducted in Austria, ABCSG 18, and with support from MedUni Vienna, the renowned Austrian Breast & Colorectal Cancer Study Group (ABCSG) has demonstrated that it is possible to protect patients from osteoporosis following endocrine cancer treatment.
results of ABCSG 18, a placebo-controlled adjuvant study involving 3,425
post-menopausal breast cancer patients, indicate with surprising
clarity that it is easy to reduce treatment-related osteoporosis and
bone fractures, which are an adverse side-effect of adjuvant endocrine
therapy with aromatase inhibitors, without exposing patients to any
If the human monoclonal antibody denosumab is
administered (twice a year by injection) as an adjuvant to this standard
therapy, the osteoporosis-related fracture rate drops by 50%. Bone
density is also increased and the number of spinal fractures is halved.
addition to the unexpectedly clear primary effect of preventing
fractures, our data shows that treatment-related fractures are a much
greater problem than previously thought," says Michael Gnant, Study
Leader, Principal of the University Department of Surgery at MedUni
Vienna, Vice-Principal of the Comprehensive Cancer Center (ECC) Vienna
and President of the ABCSG. "These data are the by far the most accurate
of any published anywhere in the world."
largest study group ABCSG, which has now been conducting studies
successfully for 30 years, is once again at the forefront of global
What is also remarkable is that denosumab treatment
is equally effective in breast cancer patients with normal bone density
and those women who already display osteopenia (reduced bone density). A
6 – 10% increase in bone density was observed in the typical risk areas
for osteoporotic fractures – femoral neck, hip and lumbar spine. Gnant
expects that these results will lead to a practice change in breast
cancer treatment worldwide: "With only two injections per year we can
protect our patients from this serious side-effect of cancer treatment –
in my opinion, this must very quickly become standard practice
The results of this ground-breaking breast
cancer study were presented to the Annual Meeting of the American
Society of Clinical Oncology (ASCO) (the world's major cancer congress)
in Chicago on 1 June and simultaneously published in the leading
European journal "The Lancet". Its practical significance was outlined
today in a press conference held in Vienna.
Osteoporosis and breast cancer – an underestimated problem?
all, the new findings provided by this important ABCSG study show that
up until now the problem of bone fractures in breast cancer patients has
been underestimated. It is not only women showing initial signs of
osteopenia who are affected by these fractures but also women displaying
completely normal bone density at the start of endocrine cancer
treatment. According to ABCSG expert Christian Singer, Vice-Principal of
the Breast Health Center at MedUni Vienna (bgz Vienna) and member of
the CCC: "If we assume that nearly one tenth of all women with breast
cancer, who receive aromatase inhibitor treatment after the menopause,
suffer from a detectable bone fracture within three years of diagnosis,
that is already a frighteningly high proportion, which clearly shows the
importance of the study results."
The largest Austrian breast
cancer study to date investigated the adjuvant administration of 60mg of
denosumab by subcutaneous injection every six months. "At this dosage
it is practically free from side-effects – such a favourable
efficacy/side-effect profile is rare in the field of cancer treatment,"
says Singer, referring to the advantages of adjuvant therapy.
from the fact that it would save the health system money, the primary
advantage of this treatment is that it would help to maintain quality of
life for patients. There is little doubt that the significant results
of this ABCSG study will lead to a relevant change in cancer treatment
in Austria, which will then be implemented worldwide in the foreseeable