Quote:
The bone drug proved disappointing though in a large study last year in postmenopausal women, who account for three-fourths of all breast cancers. But there was a glimmer of hope in the oldest patients.
“They benefitted substantially as long as they were well past menopause,” said Dr. Peter Ravdin, director of the breast cancer program at the UT Health Science Center in San Antonio, who also had no role in the research.
Other studies reported at the conference this week strengthen the view that Zometa works best in women with little estrogen.
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This article is not exactly clear. Seems to be suggesting benefit is greater when circulating estrogen is minimal.
Here is an abstract from Gnant:
Breast Dis. 2011 Dec 5. [Epub ahead of print]
Intravenous bisphosphonates for breast cancer: Impact on patient outcomes and scientific concepts.
Gnant M.
Source
Medical University of Vienna, Vienna, Austria.
Abstract
Among women worldwide, breast cancer is the most common malignancy and a leading cause of death, accounting for approximately 6% of all cancer deaths globally. The predilection of breast cancer to metastasize to bone provides a strong rationale that antiresorptive agents such as bisphosphonates may have the potential to prevent disease recurrence. Bisphosphonates are established therapies for bone loss and for preventing skeletal-related events (SREs) from bone metastases. Moreover, intravenous nitrogen-containing bisphosphonates, such as zoledronic acid, have been shown to block multiple steps in tumor metastasis (e.g., angiogenesis, invasion, and adhesion). Recent clinical data from ABCSG-12, ZO-FAST, and AZURE demonstrate that zoledronic acid can significantly improve disease-free survival (DFS) in the adjuvant breast cancer setting in women who are naturally postmenopausal or have endocrine therapy-induced menopause. Furthermore, the ABCSG-12 trial showed durable disease-free survival benefits 2 years after completion of adjuvant therapy. These data suggest a potential role for zoledronic acid beyond bone health in breast cancer. Although it is too early to determine which patients are most likely to benefit from the anticancer potential of bisphosphonates, future research will help further guide therapy in this setting.
PMID:22142663 [PubMed - as supplied by publisher]
Ther Adv Med Oncol. 2011 Nov;3(6):293-301.
Zoledronic acid in breast cancer: latest findings and interpretations.
Gnant M.
Source
Department of Surgery, Comprehensive Cancer Center, Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria.
Abstract
The intravenous nitrogen-containing bisphosphonate zoledronic acid has been shown to block multiple steps in tumor metastasis (e.g. angiogenesis, invasion, adhesion, proliferation) in preclinical and translational studies. Moreover, clinical data from the ABCSG-12 and ZO-FAST trials demonstrate significantly improved disease-free survival with zoledronic acid in the adjuvant breast cancer setting. In contrast to these two trials, recent interim results from the AZURE trial do not show a benefit from adding zoledronic acid to adjuvant therapy in the overall patient population. However, subset analyses of AZURE data show that zoledronic acid significantly improved overall survival in women who were more than 5 years postmenopausal or older than 60 years at baseline. Similarly, subset analyses of the ABCSG-12 trial data demonstrate greater benefits from zoledronic acid treatment in patients who theoretically would have achieved more complete ovarian suppression. These observations, together with the AZURE postmenopausal data, suggest that the endocrine environment may affect the potential anticancer activity of zoledronic acid. Indeed, current data support the possibility that zoledronic acid might be most effective for improving disease-free survival in the adjuvant breast cancer setting in women who are postmenopausal or have endocrine therapy-induced menopause.
PMID:22084643 [PubMed]
PMCID: PMC3210470
Free PMC Article