Currently, bisphosphonates are not regulatory approved for its use in adjuvant treatment of earlystage breast cancer patients. However, they are recommended in the ASCO/ESMO guidance for clinical practice for adjuvant treatment of breast cancer of postmenopausal patients.
The results from this study show that, independent of menopausal status, patients with MAF-negative (non-amplified) tumors treated with Clodronate had a longer survival than untreated patients (HROS= 0·59, (95% CI 0·37–0·93), p=0·02), whereas patients who had MAF-positive tumors had no benefit. The risk of death at 5 years in MAF-negative patients was reduced by 41% with clodronate adjuvant treatment. MAF-negative patients who benefited from clodronate adjuvant treatment in this study represented around 80% of all breast cancer patients.
Our results indicate that the clinical benefit of adjuvant clodronate use is restricted to MAF-negative patients. The assessment of MAF status has the potential to become an objective approach to selection of breast cancer patients for adjuvant clodronate treatment, improving the clinical outcome of the patients.
The MAF gene amplification acts like an orchestra conductor, activating and blocking a large number of genes, and it plays a key role in breast cancer metastasis, particularly in the spread to the bone. It regulates processes such as cell survival, the initiation of metastasis, metabolic rewiring, and also adhesion to cells from the bone marrow, and the formation of osteoclasts, a cell types responsible for remodeling bone.
The MAF test is developed by Inbiomotion, a spin-off from IRB Barcelona and ICREA, the test has been successfully assayed in two clinical trials, involving a total of 6,500 patients.