Cochrane · systematic review · CD003474
Bisphosphonates and other bone agents for breast cancer
O'Carrigan, B, Wong, MHF, Willson, ML, et al. · Cochrane Database of Systematic Reviews · 2017 · Cochrane Library
Breast CancerAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
19
current version
GRADE rated
19
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 0 · 0%Low 1 · 5.3%Moderate 8 · 42.1%High 10 · 52.6%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Bisphosphonates compared to placebo/observation for women with early breast cancer
Population: women with early breast cancer
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Bone metastases Bisphosphonates vs placebo/observation | RR 0.86 [0.75, 0.99] | 11 studies · 15005 participants | Moderate Downgraded: risk of bias |
Overall survival Bisphosphonates vs placebo/observation | HR 0.91 [0.83, 0.99] | 9 studies · 13949 participants | High |
Overall survival postmenopausal women Bisphosphonates vs placebo/observation | HR 0.77 [0.66, 0.9] | 4 studies · 6048 participants | High |
Overall survival: pre‐ or perimenopausal women Bisphosphonates vs placebo/observation | HR 1.03 [0.86, 1.22] | 2 studies · 3501 participants | High |
Disease‐free progression Bisphosphonates vs placebo/observation | HR 0.94 [0.87, 1.02] | 7 studies · 12578 participants | High |
Disease‐free progression: postmenopausal women Bisphosphonates vs placebo/observation | HR 0.82 [0.74, 0.91] | 7 studies · 8314 participants | High |
Disease‐free progression: pre‐ or perimenopausal women Bisphosphonates vs placebo/observation | HR 1.01 [0.9, 1.13] | 4 studies · 5493 participants | High |
Fracture incidence Bisphosphonates vs placebo/observation | RR 0.77 [0.54, 1.08] | 6 studies · 7602 participants | Moderate Downgraded: imprecision |
Osteonecrosis of the jaw (ONJ) Bisphosphonates vs placebo/observation | no estimate extracted | 9 studies · 13242 participants | High |
Infusion‐related side effects Bisphosphonates vs placebo/observation | no estimate extracted | 7 studies · 7 participants | Moderate Downgraded: risk of bias |
Bisphosphonates compared to placebo/observation for women with advanced breast cancer without bone metastases
Population: women with advanced breast cancer without bone metastases
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Bone metastases Bisphosphonates vs placebo/observation | RR 0.96 [0.65, 1.43] | 3 studies · 330 participants | Moderate Downgraded: imprecision |
Median time to a skeletal‐related event (SRE) Bisphosphonates vs placebo/observation | no estimate extracted | 1 study · 73 participants | Low Downgraded: risk of bias, imprecision |
Overall survival Bisphosphonates vs placebo/observation | RR 0.89 [0.73, 1.09] | 3 studies · 330 participants | High |
Quality of life Bisphosphonates vs placebo/observation | no estimate extracted | 1 study · 124 participants | Moderate Downgraded: risk of bias, imprecision |
Bisphosphonates compared to placebo/observation for women with metastatic breast cancer and bone metastases
Population: women with metastatic breast cancer with bone metastases
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Skeletal‐related event (SRE) Bisphosphonates vs placebo/observation | RR 0.86 [0.78, 0.95] | 9 studies · 2810 participants | High |
Median time to a skeletal‐related event Bisphosphonates vs placebo/observation | no estimate extracted | 9 studies · 2891 participants | High |
Overall survival Bisphosphonates vs placebo/observation | RR 1.01 [0.91, 1.11] | 7 studies · 1935 participants | Moderate Downgraded: inconsistency |
Bone pain Bisphosphonates vs placebo/observation | no estimate extracted | 11 studies · 3297 participants | Moderate Downgraded: risk of bias |
Quality of life Bisphosphonates vs placebo/observation | no estimate extracted | 5 studies · 1888 participants | Moderate Downgraded: risk of bias, inconsistency |