Therapeutic bone response of breast cancer recurrences on single sm-153 EDTMP treatment (+/- influence of statin intake)

Abstract : Purpose: Data comparing osteoblastic vs osteolytic recurrences of therapeutic response are still very limited. We aimed to answer this question in 164 female breast cancer patients (including 61 females on statin therapy) suffering from recurrent breast cancer who received a single dose of Sm-153 EDTMP for painful metastatic bone lesions. Methods: 164 female patients suffered from painful metastatic breast cancer with >1 up to 5 bone lesions, we evaluated the response of recurrences judged by CT as osteoblastic (BL), osteolytic (LY) or mixed (MI) showing up in bone scintigraphy to a single dose of 30mci (1.1GBq) 153Sm-EDTMP. 116 females (70.03%) suffered from ductal, 37(22.56%) from lobular, 10 (6.09%) from mixed and 1(0.61%) from medullary cancer. Statin used by the 61 female patients were Simvastatin (20 or 40 mg/day orally), Atorvastatin (20 or 40 mg/day orally) and Rosuvastatin (20 mg/day orally). Results: Bone uptake and pain response did not show any difference between BL-, LY- and MI-recurrences. No correlation of pain response and its duration vs. uptake, type, number and extent of lesions, adhesion molecules (AM) and histology was seen. Out of 164 female cancer breast, females on statins exhibited a significantly (P-value <0.01) more pronounced decrease in adhesion molecules vs. non users. Conclusion: These findings indicate no significant difference in pain response between the different types of bone recurrences. Whether, the effect of statins on adhesion molecules is a direct drug effect or reflect on antitumoral action as well as, the influence on the extent of recurrences should be examined in prospective studies.