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William J. Gradishar, MD, FACP, FASCO


ASCOBT 2023: Timing of Zoledronic Acid Use in Postmenopausal Patients Being Treated for Breast Cancer

By: Joshua D. Madera, MD
Posted: Thursday, August 31, 2023

Despite their benefit as adjuvant therapy for postmenopausal women with hormone receptor–positive, early-stage breast cancer, aromatase inhibitors significantly reduce bone density in these patients and negatively impact their quality of life, explained Professor Mai Abdel Gelil, of Assiut University, Egypt. Therefore, bisphosphonates have been employed to help reduce the extent of bone resorption and to improve patient survival. The immediate administration of zoledronic acid led to a significant reduction in bone loss and an improvement in bone pain, according to a presentation given at the 2023 American Society of Clinical Oncology (ASCO) Breakthrough meeting in Yokohama, Japan (Abstract 8).

A total of 65 postmenopausal women with hormone receptor–positive, early-stage breast cancer were recruited for the study. All patients were receiving adjuvant letrozole therapy for at least 5 years. Patients were stratified to receive treatment with 4 mg of zoledronic acid every 6 months immediately (n = 45) or at a delayed period (n = 20), as indicated by the presence of bone pain, a bone fracture, or a bone mineral density score ≤ –2.0. The bone mineral density of the lumbar spine was assessed every 3 months over 2 years to assess any treatment-related changes.

Significant differences in the bone mineral density score were immediately identified between the two treatment groups, with patients in the immediate treatment group having improved scores. The median disease-free survival was revealed as 39 ± 0.6 months and 21 ± 0.4 months for patients in the immediate- and delayed-treatment groups, respectively. Moreover, despite the delay in bisphosphonate treatment, patients reported a significant improvement in their bone pain.

Disclosure: Dr. Gelil reported no conflicts of interest.

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