J Breast Cancer. 2014 Dec;17(4):350-5. doi: 10.4048/jbc.2014.17.4.350. Epub 2014 Dec 26.

Survival benefit of zoledronic Acid in postmenopausal breast cancer patients receiving aromatase inhibitors.

Journal of breast cancer

Sung Gwe Ahn, Sung Hyun Kim, Hak Min Lee, Seung Ah Lee, Joon Jeong

PMID: 25548583 PMCID: PMC4278054 DOI: 10.4048/jbc.2014.17.4.350

Abstract

PURPOSE: A growing body of evidence indicates that zoledronic acid (ZA) can improve the clinical outcome in patients with breast cancer and low estrogen levels. In the present study, we aimed to investigate the survival benefit of ZA administration in postmenopausal Korean women with breast cancer who were also receiving aromatase inhibitors.

METHODS: Between January 2004 and December 2010, 235 postmenopausal breast cancer patients undergoing aromatase inhibitor therapy were investigated. All patients were postmenopausal, as confirmed by laboratory tests. Of these patients, 77 received adjuvant upfront ZA for at least 1 year in addition to conventional adjuvant treatment. The remaining 158 patients never received ZA and were treated according to the St. Gallen guidelines.

RESULTS: The baseline characteristics for ZA treatment were not different between the two groups. The median follow-up time was 62 months, and the patients who received ZA in addition to aromatase inhibitors showed a better recurrence-free survival compared to those who received aromatase inhibitors alone (p=0.035). On multivariate analysis, the patients who received ZA showed a better recurrence-free survival independent of the tumor size, nodal status, progesterone receptor, and histological grade. For this model, Harrell c index was 0.743. The hazard ratio of ZA use for recurrence-free survival was 0.12 (95% confidence interval, 0.01-0.99).

CONCLUSION: Our findings suggest that upfront use of ZA as part of adjuvant treatment can offer a survival benefit to postmenopausal breast cancer patients receiving aromatase inhibitor treatment.

Keywords: Aromatase inhibitors; Breast neoplasms; Postmenopause; Zoledronic acid

References

1. Ann Oncol. 2013 Feb;24(2):398-405 - PubMed
2. J Natl Cancer Inst. 2008 Aug 20;100(16):1167-78 - PubMed
3. J Korean Med Sci. 2011 Dec;26(12):1569-75 - PubMed
4. Cancer. 2008 Jul 1;113(1):193-201 - PubMed
5. N Engl J Med. 2011 Oct 13;365(15):1396-405 - PubMed
6. J Clin Oncol. 2007 Mar 1;25(7):820-8 - PubMed
7. Clin Cancer Res. 2008 Jul 15;14(14):4658-66 - PubMed
8. Stat Med. 1996 Feb 28;15(4):361-87 - PubMed
9. Eur J Cancer. 2010 May;46(7):1211-22 - PubMed
10. Clin Cancer Res. 2003 Jul;9(7):2394-9 - PubMed
11. BMC Cancer. 2014 Feb 05;14:66 - PubMed
12. J Clin Oncol. 2007 Dec 1;25(34):5418-25 - PubMed
13. Cancer Treat Rev. 2014 Apr;40(3):476-84 - PubMed
14. N Engl J Med. 2009 Feb 12;360(7):679-91 - PubMed
15. Bone. 2011 Jul;49(1):71-6 - PubMed
16. Mod Pathol. 1998 Feb;11(2):155-68 - PubMed
17. Br J Cancer. 2010 Mar 30;102(7):1099-105 - PubMed
18. Breast Cancer Res Treat. 2014 Feb;144(1):113-21 - PubMed
19. Clin Cancer Res. 2013 May 15;19(10):2755-65 - PubMed
20. Breast Cancer Res Treat. 2011 Dec;130(3):863-70 - PubMed
21. Ann Oncol. 2014 May;25(5):998-1004 - PubMed
22. Cancer. 2008 Mar 1;112(5):1001-10 - PubMed

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