The use of non-ionizing REMS technology supports longitudinal monitoring in AIs-treated BC patients
The study “Longitudinal monitoring of denosumab-associated bone changes by REMS in postmenopausal women with ER-positive breast cancer receiving aromatase inhibitors”, authored by Caffarelli and Colleagues and published on line by Aging Clinical and Experimental Research, ACER Journal, evaluated the short-term effects of Denosumab and Aromatase Inhibitors on bone health in estrogen receptor (ER)-positive breast cancer (BC) patients using Radiofrequency Echographic Multi- Spectrometry (REMS).
As we know, more and more individuals are affected by both osteoporosis and cancer, which underscores the growing need for reliable monitoring of the effects of anti- cancer therapies on bone health and, consequently, fracture risk. Adjuvant endocrine therapy is the treatment for ER-positive BC patients. Aromatase Inhibitor reduce recurrence risk but accelerate bone loss and fracture risk. Denosumab, an antiresorptive agent, shows promise in mitigating these effects.
Thus, short-, medium- and long-term follow-up assessments are crucial for accurately monitoring bone loss rates to ensure that the most appropriate pharmacological therapy is provided for each patient.
This study included 364 postmenopausal women with ER-positive breast cancer receiving Aromatase Inhibitors and evaluated treatment effects on bone health over 18 months. Longitudinal monitoring was performed at baseline and every 6 months using REMS, while DXA was performed at baseline and after 12 months because of ionizing radiation exposure. Patients were classified into those receiving Denosumab and those not receiving anti-osteoporotic therapy. The untreated group showed a progressive decline in lumbar spine and femoral BMD at all time points, whereas the denosumab group exhibited significant and sustained improvements at both skeletal sites. At 18 months, lumbar spine REMS-BMD decreased by 3.92% in untreated patients and increased by 5.28% in those treated with denosumab. This study, for the first time, quantifies the short-, medium and long-term detrimental skeletal effects of aromatase inhibitor and the protective role of Denosumab on bone density recovery, without radiation exposure. These findings support REMS as a reliable tool for longitudinal monitoring of bone health in clinical practice.
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