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Osteoporosis and breast cancer Imprimer

Rebecca Aft et al (Lancet Oncology May 10, 2010) assessed the effect of zoledronic acid on clearance of disseminated tumour cells (DTCs) from the bone marrow in women undergoing neoadjuvant chemotherapy for breast cancer in an open-label, phase 2 randomised trial. Eligible patients (n=120) had clinical stage II-III (≥T2 and/or ≥N1) newly diagnosed breast cancer, Eastern Cooperative Oncology Group performance status of 0 or 1, and normal cardiac, renal, and liver function and received 4 mg zoledronic acid intravenously every 3 weeks or no zoledronic acid for 1 year concomitant with four cycles of neoadjuvant epirubicin (75 mg/m2) plus docetaxel (75 mg/m2) and two cycles of adjuvant epirubicin plus docetaxel. The principal results were the flowing: At 3 months, 17 of 56 patients receiving zoledronic acid versus 25 of 53 patients who did not receive zoledronic acid had detectable DTCs (p=0•054). The most common grade 3-4 toxicities were infection (five of 60 patients in the zoledronic acid group and six of 59 in the control group) and thrombosis (five of 60 in the zoledronic acid and two of 59 in the control group). There was one documented case of osteonecrosis in the zoledronic acid group.
Zoledronic acid administered with chemotherapy resulted in a decreased proportion of patients with DTCs detected in the bone marrow at the time of surgery, supporting the hypothesis that the antimetastatic effects of zoledronic acid may be through effects on DTCs.


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