Advanced breast cancer: Do bisphosphonates help?

Women with breast cancer that has spread to the bones can reduce their risk of broken bones by taking bisphosphonates. It is not known, though, whether one particular bisphosphonate medication is better than others.

Cancer spreading to the bones is one of the fears with advanced breast cancer. Cancer cells move to the skeleton and start to grow there. This growth so weakens the bones that it can lead to painful bone breaks.

Researchers have been testing bisphosphonate drugs in recent years to try to find a way to protect women with advanced breast cancer from broken bones. It is known that these drugs can slow down damaging bone loss.

To assess the advantages and disadvantages of these drugs, researchers gathered and analysed the results of trials among 7,100 women with advanced breast cancer.

Their most important conclusion was that although bisphosphonates cannot completely stop bone damage from cancer, the treatment reduced the number of broken bones. However it is not possible to judge whether one particular medication is more effective than others.

The evidence suggests that these drugs only have a benefit for women in whom cancer has already spread to the bones. It does not seem as though bisphosphonates can prevent cancer spreading to the bones, and they do not appear to lengthen survival either.

Very serious adverse effects such as severe nausea, fever or calcium deficiency were uncommon in the trials.

© IQWiG (Institute for Quality and Efficiency in Health Care)