Published in part through the assistance of Baylor Charles A. Sammons Cancer Center
Dallas, TX

September 2004 | Vol. 1, No. 1
1 AMA PRA Category 1 Credit

Table of Contents

Practical Issues in Preserving Bone Health and Management of Bone Metastases in Breast Cancer

Featuring Consultations With

Julie Gralow, MD
Division of Oncology
University of Washington Cancer Center
Seattle, WA

Hope S. Rugo, MD
Clinical Professor of Medicine
Director, Breast Oncology Clinical Trials Program
University of California San Francisco
San Francisco, CA

Learning Objectives | Back to to
Upon completion of this learning material, physicians should be able to:

• Discuss information from recent clinical trials demonstrating the
  efficacy and safety of new-generation bisphosphonates in preventing skeletal complications associated with bone metastases
  
• Identify the role of bisphosphonates in the management of cancer
  treatment–induced bone loss and maintenance of bone health
  
• Evaluate the safety of long-term use of bisphosphonates in bone metastases

Activity Goals | Back to top
Management of bone disease in breast cancer requires prevention of metastatic bone disease, osseous metastases in the adjuvant setting, and cancer treatment–induced bone loss. Bone metastasis might involve discrete osteolysis, diffuse osteopenia, osteoblastic lesions, or a combination of all of these. Skeletal complications of malignancy include significant bone pain, impaired mobility, pathologic fractures, spinal cord or nerve root compressions, bone marrow infiltration, and hypercalcemia. Current therapeutic approaches for skeletal complications of malignancies include radiation therapy, chemotherapy, endocrine therapy, orthopedic interventions, analgesics, and more recently, bisphosphonates. The recent addition of bisphosphonates to standard chemotherapy or hormonal therapy has led to a decrease in skeletal complications of bone metastases because
bisphosphonates are potent inhibitors of pathologic bone resorption.

The purpose of this activity is to review the case of a patient treated with a bisphosphonate for bone metastases due to breast cancer.

Target Audience | Back to top
This publication is intended for medical oncologists involved in the care of patients with breast cancer. No specific skills or knowledge other than a basic training in oncology are required for successful participation in this activity.

Physicians’ Education Resource designates this educational activity for a maximum of 1 category 1 credit toward the AMA Physician’s Recognition Award. Each physician should claim only those credits that he/she actually spent in the activity.

Release date: September 30, 2004 Expiration date: September 30, 2005

Disclosure Policy | Back to top
As a sponsor accredited by the Accreditation Council for Continuing Medical Education, Physicians’ Education Resource must ensure balance,
independence, objectivity and scientific rigor in all its sponsored activities. All faculty participating in a sponsored activity are expected to disclose to the activity audience any significant financial interest or other relationship (1) with the manufacturer(s) of any commercial product(s) and (2) with any commercial supporters of the activity. (Significant financial interest or other relationships can include such things as grants or research support, employee, consultant, major stockholder, member of speaker’s bureau, etc.) The intent of this disclosure is not to prevent an author with a significant financial or other relationship from publishing an article, but rather to provide readers with information on which they can make their own judgements. It remains for the readers to determine whether the author’s interests or relationships may influence the publication with regard to exposition or conclusion.

Julie Gralow, MD
Grant or Research Support – Amgen, Aventis, Bristol Myers Squibb, Genentech, GlaxoSmithKline; Speaker’s Bureau – Amgen, Aventis, Bristol Myers Squibb, Genentech, GlaxoSmithKline, Lilly, Novartis, Ortho, Pharmacia

Hope S. Rugo, MD
Grant or Research Support – Novartis, Pfizer; Speaker’s Bureau – Amgen, AstraZeneca, Novartis, Pfizer

The article in this CME activity might include discussion of investigational and/or unlabeled uses of drugs. If the article includes discussion of
investigational and/or unlabeled uses of a drug, specific information is located on the article page. Please refer to the full prescribing information for each drug discussed in this newsletter for FDA-approved dosing, indications, and warnings.

Oncology Consultations is produced by Physicians’ Education Resource, Dallas, TX. An unrestricted educational grant for this publication was provided by Novartis Oncology.

The views and opinions expressed in this publication are those of the authors and do not necessarily reflect the views of the sponsor or publisher. Although great care has been taken in compiling and checking the information given in this publication to ensure accuracy, the authors, Novartis Oncology, and Physicians’ Education Resource and its servants or agents shall not be responsible or in any way liable for the continued currency of the information or for any errors, omissions, or inaccuracies in this publication, whether arising from negligence or otherwise howsoever or for any
consequences arising therefrom.

Please consult full prescribing information for any drugs or procedures discussed within.

All rights reserved. No part of this publication may be translated, reproduced, stored, or transmitted by any means or in any type of media form including electronic, mechanical photocopying, recording, broadcasting, or otherwise without prior permission from the publisher.

©Copyright 2004 by Physicians’ Education Resource. No material may be reproduced in whole or in part, in any form, without written permission from the publisher.

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Editor, Oncology Consultations
Physicians’ Education Resource
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Phone: (214) 820-8079
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Editorial Staff:
Publishing Manager – B. Diane Gambill, PhD
Assistant Publishing Manager – David Lee, PhD
Managing Editor – Jennifer Klem, PhD
Manager, CME and Content – Preeta Tyagi, PhD
Senior Medical Editor – Jay Delmar, PhD
Associate Medical Editor – Jill Cowherd
Medical Editor/Proofreader – Pete Sloan
Acquisitions – Anissa Mitchell

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