Zoledronic acid is superior to pamidronate for the treatment of bone metastases in breast carcinoma patients with at least one osteolytic lesion
Lee S. Rosen,D. Gordon,William Dugan,Pierre Major,Peter D. Eisenberg,Louise Provencher,Mary Kaminski,Joe Simeone,John J. Seaman,Bee-Lian Chen,Robert E. Coleman +10 more
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TLDR
Treatment with zoledronic acid (Zol) was compared with a dose of 90 mg of pamidronate (Pam) in breast carcinoma patients with at least 1 osteolytic lesion based on data from a Phase III, randomized trial.Abstract:
BACKGROUND
Treatment with zoledronic acid (Zol) was compared with a dose of 90 mg of pamidronate (Pam) in breast carcinoma (BC) patients with at least 1 osteolytic lesion based on data from a Phase III, randomized trial.
METHODS
Overall, 1130 patients with breast carcinoma who had all types of bone metastases (osteolytic, mixed, or osteoblastic by radiology) were randomized to receive treatment with either 4 mg of Zol or 8 mg of Zol as a 15-minute infusion or 90 mg of Pam as a 2-hour infusion every 3–4 weeks for 12 months. A skeletal-related event (SRE) was defined as a pathologic fracture, spinal cord compression, radiotherapy, or surgery to bone.
RESULTS
Among all patients with BC, the proportion of those who had an SRE (primary endpoint) was comparable between treatment groups (43% of patients who received 4 mg of Zol vs. 45% of patients who received Pam). Among patients who had breast carcinoma with at least 1 osteolytic lesion (n = 528 patients), the proportion with an SRE was lower in the 4-mg Zol group compared with the Pam group (48% vs. 58%), but this did not reach statistical significance (P = 0.058). The time to first SRE was significantly longer in the 4-mg Zol group compared with the Pam group (median, 310 vs. 174 days; P = 0.013). Moreover, multiple-event analysis demonstrated significant further reductions in the risk of developing SREs over the reduction achieved with Pam (30% in the osteolytic subset [P = 0.010] and 20% for all patients with BC [P = 0.037]).
CONCLUSIONS
The current data indicate that treatment with 4 mg of Zol was more effective than 90 mg of Pam in reducing skeletal complications in a subset of patients with breast carcinoma who had at least 1 osteolytic lesion at study entry. Cancer 2004;100:36–43. © 2003 American Cancer Society.read more
Citations
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NCCN clinical practice guidelines in oncology: hepatobiliary cancers.
Al B. Benson,Thomas A. Abrams,Edgar Ben-Josef,P. Mark Bloomston,Jean F. Botha,Bryan M. Clary,Anne M. Covey,Steven A. Curley,Michael I. D'Angelica,Rene Davila,William D. Ensminger,John F. Gibbs,Daniel Laheru,Mokenge P. Malafa,Jorge Marrero,Steven G. Meranze,Sean J. Mulvihill,James O. Park,James A. Posey,Jasgit Sachdev,Riad Salem,Elin R. Sigurdson,Constantinos T. Sofocleous,Jean-Nicolas Vauthey,Alan P. Venook,Laura W. Goff,Yun Yen,Andrew X. Zhu +27 more
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Breast Cancer, Version 3.2020, NCCN Clinical Practice Guidelines in Oncology
William J. Gradishar,Benjamin O. Anderson,Jame Abraham,Rebecca Aft,Doreen M. Agnese,Kimberly H. Allison,Sarah L. Blair,Harold J. Burstein,Chau T. Dang,Anthony D. Elias,Sharon H. Giordano,Matthew P. Goetz,Lori J. Goldstein,Steven J. Isakoff,Jairam Krishnamurthy,Janice A. Lyons,P. Kelly Marcom,Jennifer M. Matro,Ingrid A. Mayer,Meena S. Moran,Joanne E. Mortimer,Ruth O'Regan,Sameer A. Patel,Lori J. Pierce,Hope S. Rugo,Amy M. Sitapati,Karen L. Smith,Mary Lou Smith,Hatem Soliman,Erica Stringer-Reasor,Melinda L. Telli,John H. Ward,Jessica Young,Jennifer L. Burns,Rashmi Kumar +34 more
TL;DR: The NCCN Guidelines specific to the workup and treatment of patients with recurrent/stage IV breast cancer are discussed in this article.
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Zoledronic Acid Significantly Reduces Skeletal Complications Compared With Placebo in Japanese Women With Bone Metastases From Breast Cancer: A Randomized, Placebo-Controlled Trial
Norio Kohno,Kenjiro Aogi,Hironobu Minami,Seigo Nakamura,Taro Asaga,Yuichi Iino,Toru Watanabe,Carsten Goessl,Yasuo Ohashi,Shigemitsu Takashima +9 more
TL;DR: Zoledronic acid significantly reduced skeletal complications compared with placebo across multiple end points in Japanese women with bone metastases from breast cancer.
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Guidance on the use of bisphosphonates in solid tumours: recommendations of an international expert panel
Matti Aapro,Per-Anders Abrahamsson,Jean-Jacques Body,Robert E. Coleman,Ramon Colomer,Luís Costa,L. Crino,Luc Dirix,Michael Gnant,Julie R. Gralow,Peyman Hadji,Gabriel N. Hortobagyi,Walter Jonat,Allan Lipton,Alain Monnier,Alexander H.G. Paterson,René Rizzoli,Fred Saad,Beat Thürlimann +18 more
TL;DR: An interdisciplinary expert panel of clinical oncologists and of specialists in metabolic bone diseases assessed the widespread evidence and information on the efficacy of BP in the metastatic and nonmetastatic setting, as well as ongoing research on the adjuvant use of BP and recommends amino-bisphosphonates for patients with metastatic bone disease from breast cancer and zoledronic acid for Patients with other solid tumours as primary disease.
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NCCN Task Force Report: Bone Health in Cancer Care
Julie Gralow,J. Sybil Biermann,Azeez Farooki,Monica Fornier,Robert F. Gagel,Rashmi Kumar,Georgia Litsas,Rana R. McKay,Donald A. Podoloff,Sandy Srinivas,Catherine Van Poznak +10 more
TL;DR: This report summarizes issues surrounding bone health in cancer care presented and discussed during this NCCN Bone Health in Cancer Care Task Force meeting in December 2012.
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