Balazs Halmos, Professor of Medicine at Montefiore Health System, shared Daniel V. Araujo’s, Associate Professor at University of Florida and Medical Director for Biospecimen Resources at UF Health Cancer Center, post on X, adding:
“Nice to see a trial on this!
As a thoracic oncologist I feel very uncertain as to optimal use of bone-targeting agents.
- Which?
- How frequently?
- For whom?
E.g. patients with generally poor (ES-SCLC) or great (eg ALK/ROS) outcome spectrum benefit at all?
Anyways, I personally already use the ‘REDUSE‘ schedule of q3m and now will feel even good about it…”
Quoting Daniel V. Araujo’s post:
“REDUSE (SAKK 96/12) at ASCO 2026 (Abstr 1004, oral): Can denosumab be de-escalated in bone-metastatic cancer without losing skeletal protection?
In patients with breast cancer or CRPC and ≥3 bone metastases (n=1,380), denosumab every 12 weeks – after 4x monthly loading – was tested for non-inferiority against the standard every-4-weeks schedule for symptomatic skeletal events (SSE).
Primary endpoint met: Stratified HR 1.02 (90% CI 0.87–1.20), median time to first SSE ~56 mo in both arms. First-and-subsequent SSE also non-inferior (HR 1.04). Less toxicity with Q12W: hypocalcemia 30% vs 46%, ONJ 6.9% vs 8.5%.
My take: Same skeletal protection, fewer injections, less toxicity, lower cost – this should be the new standard of care for bone-metastatic breast and prostate cancer. In my opinion the biology likely extends beyond these two tumors too, though the trial only tested them. One open question: the Q12W arm still got 4x monthly loading up front – do we actually need that induction phase, or could we de-escalate from the start?
Looking forward to seeing the presentation!”
Title: Prevalence of symptomatic skeletal events (SSE) with reduced denosumab (Dmab) dose density (every 12 weeks versus every 4 weeks): A randomized phase III non-inferiority trial SAKK 96/12 REDUSE.
Author: Roger Von Moos
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