Research progress in antitumor effects of zoledronic acid in early breast cancer / 中国肿瘤临床

ABSTRACT

Adjuvant treatment, which includes chemotherapy and endocrine therapy, for early breast cancer may impair bone den-sity, resulting in bone loss. The third generation bisphosphonate-zoledronic is an anti-resorptive agent that inhibits osteoclast-mediated bone resorption. This drug can be mainly used in the treatment of hypercalcemia caused by bone metastases of the cancer. The Zome-ta-Femara Adjuvant Synergy Trial revealed that immediate zoledronic acid and endocrine therapy not only prevents bone loss, but also reduces recurrence. The Austrian Breast and Colorectal Cancer Study Group-12 (ABCSG-12) also confirmed that zoledronic acid, when combined with endocrine therapy, could reduce the risk of cancer disease progression and death. Moreover, preclinical studies and clini-cal trials have demonstrated the synergistic antitumor effects of chemotherapy and zoledronic acid. Neo-adjuvant zoledronic acid to re-duce recurrence trials showed that the addition of zoledronic acid to adjuvant chemotherapy significantly reduced the risk of disease pro-gression and death in postmenopausal women more than five years postmenopause at the beginning of the study or over 60 years of age at the baseline. The ABCSG-12 subgroup analysis based on age (≤40 years or>40 years) also showed that zoledronic acid can signifi-cantly improve the prognosis in women who were over 40 years at the study entry. These results suggest that zoledronic acid administra-tion in patients with lowered estrogen levels (naturally or as a consequence of adjuvant treatment) easily exerts anti-tumor effects. How-ever, the optimal dose and duration of zoledronic acid requires further studies. More clinical trials should be performed to provide suffi-cient evidence to support the effectiveness of zoledronic acid in the treatment of early breast cancer.