Zometa inf

[JennyB]

Hi Ladies,

I have just moved interstate and have a new onc who I have not met yet but who called me the other day to discuss my Zometa infusions. I have had 1 inf and was scheduled to have 2 x yearly and was very happy with this decision after seeing on here others having the same.

However I am now in West Australia and they do not recognise this treatment method for Osteopena (sp?). The onc is going to contact my old onc to discuss reasoning and has said if I really want to continue he will but says the trials are not supporting its use for either assisstance with bone density or the slight reduction of bone mets occurance?

Any advice would be gratefully received

Thanks

Jenny

[Jackie07]

Hi Jenny,

Hope the following two abstracts will be of help:

J Natl Cancer Inst. (http://www.ncbi.nlm.nih.gov/pubmed/22752060) 2012 Jul 2. [Epub ahead of print]
Effects of Bone-Targeted Agents on Cancer Progression and Mortality.
Coleman R (http://www.ncbi.nlm.nih.gov/pubmed?term=Coleman%20R%5BAuthor%5D&cauthor=true&cauthor_uid=22752060), Gnant M (http://www.ncbi.nlm.nih.gov/pubmed?term=Gnant%20M%5BAuthor%5D&cauthor=true&cauthor_uid=22752060), Morgan G (http://www.ncbi.nlm.nih.gov/pubmed?term=Morgan%20G%5BAuthor%5D&cauthor=true&cauthor_uid=22752060), Clezardin P (http://www.ncbi.nlm.nih.gov/pubmed?term=Clezardin%20P%5BAuthor%5D&cauthor=true&cauthor_uid=22752060).
Source
Affiliations of authors: Academic Unit of Clinical Oncology, Weston Park Hospital, Cancer Research United Kingdom (CR-UK)/Yorkshire Cancer Research (YCR) Sheffield Cancer Research Centre Sheffield, UK (RC); Medizinische Universität Wien, Universitätsklinik für Chirurgie Vienna, Austria (MG); Institute of Cancer Research, Royal Marsden National Health Service Foundation Trust London, UK (GM); Inserm, Faculté de Médecine Lyon-Est (domaine Laennec) Lyon, France (PC).
Abstract
Bone-targeted treatments with bisphosphonates and denosumab, which reduce bone resorption, are known to reduce the risk of skeletal complications and prevent treatment-induced bone loss in patients with malignant bone disease. Additionally, these drugs may modify the course of bone destruction via inhibitory effects on the "vicious cycle" of growth factor and cytokine signaling between tumor and bone cells within the bone marrow microenvironment. Effects of the drugs on the stem cell niche, direct effects on the cancer cells, and immune modulation may also contribute. In early-stage (stages I, II, and III) breast cancer, treatment with the bisphosphonate zoledronic acid has shown improvements in disease-free and overall survival. Improved survival was particularly notable in women with established menopause at diagnosis and in premenopausal women with endocrine-responsive disease who received treatment with goserelin, which suppresses ovarian function by inhibiting the production of ovarian hormones. Additionally, in castrate-resistant prostate cancer, treatment with denosumab delays the development of bone metastases. These results strongly support the adjuvant use of bone-targeted treatments but suggest that reproductive hormones are an important treatment modifier to take into account. In advanced-stage (stage IV, ie, metastatic) cancers, survival benefits have been observed in patients with multiple myeloma and in patients with other solid tumors with rapid rates of bone destruction who received treatment with zoledronic acid. Here, we have critically reviewed the increasing evidence to support a disease-modifying effect of bone-targeted treatment and discussed the impact on clinical management


Ann Oncol. (http://www.ncbi.nlm.nih.gov/pubmed/22730099) 2012 Jun 22. [Epub ahead of print]
The impact of menopause on bone, zoledronic acid, and implications for breast cancer growth and metastasis.
Hadji P (http://www.ncbi.nlm.nih.gov/pubmed?term=Hadji%20P%5BAuthor%5D&cauthor=true&cauthor_uid=22730099), Coleman R (http://www.ncbi.nlm.nih.gov/pubmed?term=Coleman%20R%5BAuthor%5D&cauthor=true&cauthor_uid=22730099), Gnant M (http://www.ncbi.nlm.nih.gov/pubmed?term=Gnant%20M%5BAuthor%5D&cauthor=true&cauthor_uid=22730099), Green J (http://www.ncbi.nlm.nih.gov/pubmed?term=Green%20J%5BAuthor%5D&cauthor=true&cauthor_uid=22730099).
Source
Department of Gynecology, Endocrinology, and Oncology, Philipps-University of Marburg, Marburg, Germany.
Abstract
Recent data from the AZURE, ABCSG-12, and ZO-FAST clinical trials have challenged our understanding of the potential anticancer activity of zoledronic acid (ZOL). Although the results of these studies may appear to be conflicting on the surface, a deeper look into commonalities among the patient populations suggest that some host factors (i.e. patient age and endocrine status) may contribute to the anticancer activity of ZOL. Indeed, data from these large clinical trials suggest that the potential anticancer activity of ZOL may be most robust in a low-estrogen environment. However, this may be only part of the story and many questions remain to be answered to fully explain the phenomenon. Does estrogen override the anticancer activity of ZOL seen in postmenopausal women? Are hormones other than estrogen involved that contribute to this effect? Does the role of bone turnover in breast cancer (BC) growth and progression differ in the presence of various estrogen levels? Here, we present a review of the multitude of factors affected by different endocrine environments in women with BC that may influence the potential anticancer activity of ZOL.

[JennyB]

Thank you Jackie for posting those - if I am reading them correctly they support the use of Zometa which is what I thought. I am going to try to push my onc to continue with the treatment he said he would try to find the funding as it is not covered.

does anyone here have this treatment without having bone mets?

Thanks again Jackie

Jenny

[karen z]

Do your research and then discus........or inform!

[Jackie07]

Several members (without bone mets) have used it...

http://her2support.org/vbulletin/showthread.php?t=54210&highlight=zometa

[suzan w]

I have had 2 infusions for severe osteoporosis...

[Pray]

Hi Jenny, I do not have bone mets and I recieve zometa twice a year and my bc bs covers it. I do hope yours will be covered too.