NEW YORK (Reuters Health) Dec 19 - Disappointing results from women with bone-only breast cancer metastases who took zoledronic acid to reduce skeletal complications: treatment didn't prolong either disease-free or overall survival.
"In patients with bone-only metastasis, we could not demonstrate antitumor effects of zoledronic acid," concluded Dr. Naoto T. Ueno, at the University of Texas MD Anderson Cancer Center in Houston, and colleagues.
In a December 2nd online paper in Cancer, they note that bisphosphonates have had direct and indirect antitumor effects in preclinical studies. They had hoped that breast cancer patients with bone-only metastases, who generally have relatively long survival, would do even better if zoledronic acid or pamidronate were added to standard therapies.
To test their idea, they identified 314 such patients seen at MD Anderson over a 10-year period. When bone disease was recognized, 172 patients received zoledronic acid, 77 received pamidronate, and 65 did not receive a bisphosphonate.
On univariate analysis, progression-free survival was better with no bisphosphonate than with pamidronate (hazard ratio 0.57; p=0.002). The difference in progression-free survival between no treatment and zoledronic acid was not statistically significant (HR 0.72; p=0.058).
After adjustment for factors such as menopausal status and number of bone metastases, on multivariate analysis there was still no significant difference in progression-free survival between the no-bisphosphonate group and the zoledronic acid group (HR 0.80; p=0.235), the report shows.
The same held true for overall survival, with a hazard ratio of 1.34 (p=0.192) in multivariate analysis, Dr. Ueno and colleagues found.
"A present, the use of zoledronic acid for patients with bone metastases is the gold standard because it significantly reduces or prevents skeletal-related events," they point out.
However, it does not appear to prolong survival and any antitumor effect "remains controversial," they conclude. "Patients and physicians should have a clear understanding of the potential benefits of bisphosphonate treatment."
SOURCE: http://bit.ly/vMWbSW
Cancer 2011.
"In patients with bone-only metastasis, we could not demonstrate antitumor effects of zoledronic acid," concluded Dr. Naoto T. Ueno, at the University of Texas MD Anderson Cancer Center in Houston, and colleagues.
In a December 2nd online paper in Cancer, they note that bisphosphonates have had direct and indirect antitumor effects in preclinical studies. They had hoped that breast cancer patients with bone-only metastases, who generally have relatively long survival, would do even better if zoledronic acid or pamidronate were added to standard therapies.
To test their idea, they identified 314 such patients seen at MD Anderson over a 10-year period. When bone disease was recognized, 172 patients received zoledronic acid, 77 received pamidronate, and 65 did not receive a bisphosphonate.
On univariate analysis, progression-free survival was better with no bisphosphonate than with pamidronate (hazard ratio 0.57; p=0.002). The difference in progression-free survival between no treatment and zoledronic acid was not statistically significant (HR 0.72; p=0.058).
After adjustment for factors such as menopausal status and number of bone metastases, on multivariate analysis there was still no significant difference in progression-free survival between the no-bisphosphonate group and the zoledronic acid group (HR 0.80; p=0.235), the report shows.
The same held true for overall survival, with a hazard ratio of 1.34 (p=0.192) in multivariate analysis, Dr. Ueno and colleagues found.
"A present, the use of zoledronic acid for patients with bone metastases is the gold standard because it significantly reduces or prevents skeletal-related events," they point out.
However, it does not appear to prolong survival and any antitumor effect "remains controversial," they conclude. "Patients and physicians should have a clear understanding of the potential benefits of bisphosphonate treatment."
SOURCE: http://bit.ly/vMWbSW
Cancer 2011.
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