Denosumab Therapy and Cardiovascular Morbidity in Patients With Breast Cancer

By: Joshua D. Madera, MD
Posted: Wednesday, March 6, 2024

For women with early-stage breast carcinoma who are initiating maximal estradiol suppression, the use of the monoclonal antibody denosumab may assist in regulating changes in body composition and metabolic parameters, according to a study published in The Journal of Clinical Endocrinology & Metabolism. Given the increased risk of cardiovascular disease in breast cancer survivors that may be associated with metabolic derangements, additional studies focused on elucidating this relationship are warranted, suggested Sabashini K. Ramchand, MBBS, of the University of Melbourne, Victoria, Australia, and colleagues.

“The leading cause of death in breast cancer survivors is cardiovascular disease, not the cancer itself, and adverse metabolic changes may contribute to this risk. As such, further longer-term prospective clinical studies are needed to determine the clinical relevance of these findings,” the investigators stated.

A total of 68 premenopausal women with early-stage, estrogen receptor–positive breast cancer were recruited for the double-blind, placebo-controlled study. All patients were initiating combined ovarian function suppression with gonadotropin-releasing hormone analogs or bilateral oophorectomy and aromatase inhibition. Patients were randomly assigned to receive denosumab (n = 34) or a placebo (n = 34) at baseline and at the 6-month interval. Patients were expected to attend regular follow-up visits to assess clinical outcomes.

The study findings revealed a significantly reduced amount of android (–266 g) and gynoid (–452 g) fat mass in patients who received denosumab therapy compared with patients treated with the placebo. In addition, patients treated with denosumab demonstrated a nonsignificant decrease in total fat mass (–1,792 g) and waist circumference (–3.77 cm) compared with controls. Furthermore, no significant benefits of denosumab therapy were observed when comparing changes in body mass index, fasting glucose, hip circumference, lean mass, or lipid profile.

Disclosure: For full disclosures of the study authors, visit academic.oup.com.

The Journal of Clinical Endocrinology & Metabolism