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Journal of Clinical Pathology 2009;62:474-476; doi:10.1136/jcp.2008.062505
Copyright © 2009 by the BMJ Publishing Group Ltd & Association of Clinical Pathologists.

SHORT REPORT

Vascular endothelial growth factor activity after switching of bisphosphonate treatment for metastatic breast cancer

E Amir, M Trinkaus, C E Simmons, G Dranitsaris, M J Clemons

Division of Medical Oncology, Princess Margaret Hospital, Toronto, Ontario, Canada

Correspondence to:
Dr M Clemons, Medical Oncology, Princess Margaret Hospital (5-205), 610 University Avenue, Toronto, ON M5G 2M9, Canada; mark.clemons{at}uhn.on.ca

ABSTRACT

Background: Recent data have shown a fall in vascular endothelial growth factor (VEGF) concentrations after bisphosphonate (BP) treatment in BP-naïve patients. It has therefore been proposed that BPs may have in vivo anti-VEGF effects.

Aims: To explore whether VEGF concentrations change after administration of a more potent BP in patients receiving long-term BP treatment.

Methods: 31 patients with breast cancer who had progressive metastatic bone disease despite treatment with early-generation BPs were switched to zoledronic acid. Serum VEGF concentrations were measured at baseline, and weeks 1, 2, 3, 4, 8 and 12.

Results: VEGF concentration per platelet count did not change significantly at any time during the 12 weeks after treatment with zoledronic acid.

Conclusions: Switching to zoledronic acid did not suppress circulating serum VEGF concentrations in BP-pretreated patients. Novel approaches to assess the effect of BPs on the bone milieu may provide further insight into the possible antiangiogenic properties of BPs.


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