Xgeva every 3 months for bone mets – pro
Several studies have bee reported using Xgeva every 3 months.
The indication in this case is for metastases. A recent review of 5 studies was published by Hutton. Five relevant studies (n=1287 patients) were identified. . Observations from the included studies suggest there is potential that 3 month de-escalated treatment may provide similar benefits compared to 34 weekly treatment and that lower doses of zoledronic acid and denosumab might be equally effective. The author concluded that : “Five relevant studies (n=1287 patients) were identified. Sample size ranged from 38 to 425. Information on outcomes including occurrence of SREs, bone pain, urinary N-telopeptide concentrations, serum C-telopeptide concentrations, pain medication use and safety outcomes was not consistently available. Two trials were non-inferiority studies, two dose-response evaluations and one was a pilot study. Bone-targeted agents use varied between studies, as did duration of prior therapy. Patient populations were considered heterogeneous in several ways, and thus no meta-analyses were performed. Observations from the included studies suggest there is potential that 3 month de-escalated treatment may provide similar benefits compared to 34 weekly treatment and that lower doses of zoledronic acid and denosumab might be equally effective.
Conclusions
Studies comparing standard and de-escalated treatment with bone-targeted agents in breast cancer are rare. The benefits of standard treatment compared to de-escalated therapy on important clinical outcomes remain unclear. Future pragmatic studies must be conducted to determine the merits of this approach.”Studies comparing standard and de-escalated treatment with bone-targeted agents in breast cancer are rare. The benefits of standard treatment compared to de-escalated therapy on important clinical outcomes remain unclear. Future pragmatic studies must be conducted to determine the merits of this approach”.
Brian Hutton. A systematic review of dosing frequency with bone-targeted agents for patients with bone metastases from breast cancer. Journal of Bone Oncology Volume 2, Issue 3, September 2013, Pages 123-131
NCCN, Cancer Supportive 2017
Prescribing Information, Xgeva 2017