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Procollagen Peptide May Predict Bone Metastases in Women With Primary Breast Cancer

Researchers from the United Kingdom and Finland presented the results from a study comparing bone marrow density and serum biochemical markers of bone turnover where bone-specific alkaline phosphatase, carboxyterminal telopeptide of type I collagen, and nterminal procollagen peptide of type I collagen (PINP) were analyzed at one and two years. A total of 498 women with breast cancer were entered in the trial and received either clodronate (a bisphosphonate that reduces osteoclast activity) (n = 243) or a placebo (n = 255). Bone marrow density was measured by dual x-ray absorptiometry at trial entry and annually. The researchers found a significant correlation between oral clodronate and an increase in mean bone marrow density in the spine and hip after two years. This increase was associated with a significant decrease in serum PINP. Patients in the control placebo group demonstrated a significant decrease in bone marrow density in the spine and hip. The serum PINP was significantly higher at one and two years in women who developed bone metastases during a median of 5.5 years of follow-up. The researchers concluded that serum PINP levels may be useful as an early marker of bone metastases and may help in selecting appropriate long-term treatment for patients with breast cancer.