2088P - Management of cancer treatment-induced bone loss in patients with breast and hormone sensitive prostate cancer: AIOM survey among Italian oncologists

Background

Cancer treatment–induced bone loss (CTIBL) is a side effectof hormonal therapy (HT) that can severely affect patients' quality of life. The first aim of this survey is to obtain an updated snapshot of Italian management of bone health in patients with breast cancer (BC) undergoing adjuvant HT and in patients with hormone sensitive prostate cancer (PC). The secondary aim is to evaluate overlaps and differences between Italian and European recommendations.

Methods

Our survey was made up of 21 multiple-choice questions: the first part dealt with the respondents’ characteristics, while the second with management of CTIBL in the described setting. An invitation to complete it was sent by e-mail to 2336 Italian oncologists in October 2022.

Results

121 (5.2%) Italian oncologists completed the survey. In most cases (57%) the oncologists themselves take charge of the management of CTIBL. At the beginning of HT, most of respondents require bone health diagnostic exams, such as dual-energy X-ray absorptiometry (89%), repeated with different timing. A large part of oncologists starts bone health therapy regardless of T-score or other exams (44%), according to Italian guidelines; while another part start therapy only in case of increased fracture risk (38%), according to ESMO guidelines. Main reported reasons for prescribing antiresorptive drugs are modifying fracture risk (87%), densitometry values (75%) or antitumoral effect (34%). The antiresorptive drugs or supplementation of calcium and vitamin D alone are prescribed in 58% and 38% of patients with BC and 42% and 39% of patients with PC, respectively. Lastly, 6% and 13% of respondents interrupt therapy at the end or 6 months after HT, respectively; 36% after instrumental or scoring reassessment; 22% do not interrupt it; and 23% refer the patient to specialist. Most respondents claim to follow Italian (88%) and European guidelines (31%).

Conclusions

The heterogeneous Italian management of CTIBL arisen from this survey highlights the need both to standardize guidelines and to make oncologists more aware of this topic. It would be interesting to extend this survey to other European countries.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

M. Di Maio: Financial Interests, Personal, Advisory Board, Consultancy about clinical trial methodology and clinical trial results interpretation: Novartis; Financial Interests, Personal, Advisory Board, Consultancy about immunotherapy in SCLC: Roche; Financial Interests, Personal, Advisory Board, Consultancy about role and interpretation of patient-reported outcomes and quality of life in clinical trials: Takeda; Financial Interests, Personal, Advisory Board, Advisory board about the role of chemotherapy and hormonal treatment in hormone-sensitive prostate cancer: Janssen; Financial Interests, Personal, Advisory Board, Consultancy about the results obtained with lorlatinib and dacomitinib in advanced non-small cell lung cancer: Pfizer; Financial Interests, Personal, Advisory Board, Consultancy about role of osimertinib as adjuvant treatment of NSCLC: AstraZeneca; Financial Interests, Personal, Invited Speaker, Compensation for a talk and a document about role of patient-reported outcomes in clinical trials and in clinical practice, with a specific focus on lung cancer: Boehringer Ingelheim; Financial Interests, Personal, Advisory Board, Participation in advisory boards about olaparib in pancreatic cancer, about olaparib in prostate cancer, and about immunotherapy in lung cancer: Merck Sharp & Dohme; Financial Interests, Personal, Advisory Board, Consultant for the new indication of avelumab in urothelial cancer: Merck Serono; Financial Interests, Institutional, Research Grant, Financial support and drug supply for the Meet-URO12 trial (niraparib as maintenance treatment of urothelial carcinoma after first-line treatment with platinum-based chemotherapy): Tesaro - GSK; Financial Interests, Institutional, Local PI, Local PI of trial with tislelizumab in hepatocellular carcinoma: BeiGene; Financial Interests, Institutional, Local PI, Local PI of a trial with cabozantinib and atezolizumab in advanced HCC: Exelixis; Financial Interests, Institutional, Local PI, Local PI of a trial with atezolizumab and bevacizumab in advanced HCC: Roche; Financial Interests, Institutional, Local PI, Local PI of trials with pembrolizumab in hepatocellular carcinoma: Merck Sharp & Dohme; Financial Interests, Institutional, Local PI, Local PI of a trial with sasanlimab in NMI bladder cancer: Pfizer. D. Santini: Financial Interests, Personal, Advisory Board: Janssen, Astellas, MSD, AstraZeneca, Roche, Merck, Bayer, Novartis, Lilly, Amgen. U.F.F. De Giorgi: Financial Interests, Personal, Other, Consultant: Janssen, Astellas Pharma, Sanofi, Bayer, Pfizer, Bristol Myers Squibb, Novartis, Ipsen, Merck; Financial Interests, Institutional, Funding: Roche, Sanofi, AstraZeneca; Non-Financial Interests, Personal, Other, Travel accommodation: Janssen-Cilag, Ipsen. All other authors have declared no conflicts of interest.