Calcium2026-06

Romosozumab for cancer treatment-induced bone loss in postmenopausal women with hormone receptor-positive breast cancer: a case series.

Tsujino Shohei, Koyanagi Hirotaka, Sawamura Chigusa, Tozuka Katsunori et al. — Archives of osteoporosis

Summary

This small study explored how a drug called Romosozumab affected bone density in postmenopausal women with hormone receptor-positive breast cancer who were experiencing bone loss due to their cancer treatment. The findings suggest that Romosozumab, when given alongside calcium and vitamin D, may help increase bone density in this specific group. However, because it was a small case series, more extensive research is needed to confirm these results.

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Key points

Romosozumab was linked to improved bone density in postmenopausal breast cancer patients.
These patients experienced bone loss as a side effect of their cancer treatment.
All participants also received calcium and vitamin D supplements.
This was a small study, so further research is needed to confirm the findings.

What the study looked at

What question the study asked: Researchers investigated whether a medication called Romosozumab could help improve bone health in postmenopausal women with hormone receptor-positive breast cancer who were experiencing bone loss due to their cancer treatments. How it was studied: This was a retrospective analysis of 22 women at a single institution. These women, who had non-metastatic breast cancer and treatment-induced bone loss, received Romosozumab for 12 months. Importantly, all participants also took calcium and/or active vitamin D supplements. The study looked at changes in bone mineral density and monitored for fractures or cancer recurrence. What it found: The study observed that after 12 months, participants showed significant increases in bone mineral density in both the spine and hip. No new bone fractures or signs of cancer recurrence were noted during the treatment and follow-up period. The authors caution that these results are from a small group and require confirmation through larger, more controlled studies.

Dietary takeaway

While this study focused on a specific medication, it's important to note that all participants received calcium and vitamin D supplementation. This highlights the ongoing importance of adequate calcium intake, whether from dairy products, fortified foods, leafy greens, or supplements, to support bone health, especially for individuals at risk of bone loss. Remember, this was a small preliminary study, and its findings are not definitive for everyone.

Abstract

UNLABELLED: Romosozumab was associated with increases in bone mineral density in postmenopausal women with hormone receptor-positive breast cancer and cancer treatment-induced bone loss (CTIBL). No clinical signals of fracture occurrence or cancer recurrence were observed; however, these findings are based on a small retrospective case series and require confirmation in larger prospective studies. BACKGROUND: Cancer treatment-induced bone loss (CTIBL) is a major complication in postmenopausal women with hormone receptor-positive breast cancer receiving aromatase inhibitor therapy. Although antiresorptive agents are commonly used, some patients continue to experience progressive bone loss or fragility fractures. Romosozumab, a monoclonal antibody against sclerostin, has demonstrated efficacy in postmenopausal osteoporosis; however, clinical data in patients with cancer remain limited. METHODS: We retrospectively analyzed 22 postmenopausal women with clinically non-metastatic (Stage I-III) hormone receptor-positive breast cancer who received romosozumab for CTIBL at a single institution. Romosozumab was administered for 12 months in patients with progressive bone loss, new fragility fractures, or high fracture risk. All patients received concomitant calcium and/or active vitamin D supplementation. Changes in bone mineral density (BMD), bone turnover markers, and tumor markers (CA15-3, CEA) were evaluated. Differences in skeletal response were also evaluated between treatment-naïve patients and those with prior exposure to bone-modifying agents. Clinical outcomes, including new fragility fractures and cancer recurrence, were assessed during follow-up. RESULTS: The mean age of the patients was 66.8 years, and the mean duration of aromatase inhibitor therapy prior to treatment was 35.3 months to 36.9 months. After 12 months of romosozumab treatment, lumbar spine BMD increased by 11.5% (P < 0.001), and total hip BMD increased by 4.1% (P = 0.002). Changes in bone turnover markers were observed, consistent with the known mechanism of action of romosozumab. No new fragility fractures were observed during the treatment period. During a mean follow-up period of 38.3 months (including the 12-month treatment period), tumor markers remained stable, and no clinical evidence of cancer recurrence was observed. CONCLUSIONS: In this small retrospective case series, romosozumab was associated with increases in BMD in postmenopausal women with hormone receptor-positive breast cancer and CTIBL. No clinical signals suggestive of short-term oncological deterioration were observed; however, given the limited sample size, retrospective design, and lack of a control group, these findings should be interpreted with caution. Further prospective studies with larger cohorts and longer follow-up are required to better define the efficacy and safety of romosozumab in this population.

View on PubMed →DOI: 10.1007/s11657-026-01724-7