Zometa and the AIs
The concern about bone loss, diminishing bone density, is real for many women being treated for breast cancer. Yes, it is wonderful that new treatments have extended many lives, but they have also brought complications and new problems. Worry about bone loss is especially relevant for women taking any of the AIs and women who experience a chemically-induced (from chemotherapy) menopause years earlier than the natural process would have evolved.
As many of us have watched our annual bone density tests worsen and obsessively exercised, taken Calcium and Vit D, and, perhaps, one of the bisphosphonates, we have been gratified by evidence that it all helps. A more recent finding has been the possible value of these drugs in reducing the risk of bone mets. There are currently clinical trials underway to study the value of adding Zomenta to adjuvant chemotherapy.
This summary is a quick report on the value of Zometa to bone health:
Zoledronic acid for treatment of osteopenia and osteoporosis in women with primary
breast cancer undergoing adjuvant aromatase inhibitor therapy
The Breast, 01/21/10
Hines SL et al. - Postmenopausal women with osteoporosis/osteopenia are at increased risk of
fracture. Aromatase inhibitors further increase bone loss in these patients. This study evaluates
whether zoledronic acid prevents the bone loss expected when these patients initiate letrozole.
Zoledronic acid prevents bone loss in postmenopausal women with osteoporosis/osteopenia
starting letrozole and is associated with improvements in BMD.
• Postmenopausal women with estrogen and/or progesterone receptor-positive breast
cancer and a bone mineral density (BMD) T-score < ?2.0 were given letrozole
2.5mg/vitamin D 400 international units daily, calcium 500mg twice daily, and 4mg
zoledronic acid every 6months.
• BMD was assessed at baseline and 1year
• Primary endpoint was the mean change in lumbar spine (LS) BMD at 1year
• 46 patients completed 1year of treatment
• LS BMD increased by 2.66% (p=0.01), femoral neck (FN) by 4.81% , and any measured
endpoint by 4.55%