Work

Real-life use of bone-targeting agents for bone metastases in France between 2009 and 2018: Results of the OPTIMOS study

Year: 2026

Type: article

Abstract: • Bone-targeting agents (bisphosphonates, denosumab) reduce skeletal complications and improve quality of life. • Bone-targeting agents should be initiated in bone metastatic patients (ESMO 2020 guidelines). • In real life, less than 10 % of bone metastatic patients did receive bone-targeting agents in France. • Early initiation (<3 months) of bone-targeting agents effectively reduces skeletal complications. • Bone metastasis management should be improved. To determine the use of bone-targeting agents (BTAs) in clinical practice in France and the occurrence of skeletal-related events (SREs) in cancer patients with bone metastases. This study analysed data, recorded prospectively in a French National Health Insurance database, for patients who had a first diagnosis of bone metastases between 2009 and 2018. A total of 6,663 patients were analysed (mean age 69.7 ± 13.2 years, 53.2 % male) corresponding to 2,363 bone metastases only patients and 4,300 patients with SREs at inclusion. The most frequent primary cancers were breast (15.8 %), prostate (13.4 %), lung (12.6 %) and digestive cancer (10.6 %). Six-hundred and twenty-one patients (9.3 %) were treated with BTAs (52.7 % with denosumab). Median [IQR] time between inclusion and BTA initiation was similar with denosumab (3.3 months [1.2–7.9]) and bisphosphonates (3.3 months [1.2–8.7]). Patients with a SRE at inclusion and early BTA initiation (≤3 months) had a significative lower incidence of a second SRE at 12 months than those with late initiation (13.6 % [95 %CI: 8.1–20.4] vs. 21.6 % [14.8–29.2] respectively; p < 0.001). BTAs are underused in bone metastases patients in France. There is an urgent need to optimise bone metastases management in accordance with ESMO 2020 guidelines.

Source: Journal of bone oncology

DOI: 10.1016/j.jbo.2025.100738