Should de-escalation of bone-targeted agents be standard of care for patients with bone metastases from breast cancer? A systematic review and meta-analysis.

e17711 Should de-escalation of bone-targeted agents be standard of care for patients with bone metastases from breast cancer? A systematic review and meta-analysis Background: De-escalation of bone-targeted agents, such as bisphosphonates and denosumab, from 3-4 weekly to less frequent dosing is increasingly being explored in patients with bone metastases from breast cancer. As of yet, it is unclear whether there is enough evidence to support de-escalation as a standard of care. Methods: A systematic review of randomised trials comparing de-escalated (q12-weekly) versus standard schedules (q3-4-weekly) of bone-targeted therapies was performed following PICOS criteria. Medline, Embase (ASCO, ESMO, SABCS), and Cochrane Register of Controlled Trials were searched up until November 2014 with no date restrictions. All citations were reviewed by a minimum of 2 individuals. Outcomes included; skeletal related event (SRE) rates. Random effects meta-analyses were pursued when studies were judged to be homogeneous....