Prostate news article, August 2005
RANDOMISED, OPEN LABEL, PROSPECTIVE STUDY SUGGESTS ZOLEDRONIC ACID MAY PREVENT THE DEVELOPMENT OF BONE METASTASES IN PATIENTS WITH ADVANCED CANCER Article in Medical Oncology, July 2005 Reviewed by: Professor Roger S Kirby |
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Zoledronic acid is a bisphosphonate approved for the treatment of bone related complications in patients with solid tumours. In prostate cancer patients, it may be used for patients with bone mineral loss associated with androgen deprivation. While in vitro data suggest that these medications may induce cell apoptosis, their role in the prevention of bone metastases in patients with androgen independent prostate cancer remains a matter of debate.
Mystaidou and colleagues performed an open-label randomized trial in 40 patients with advanced cancer without bone metastases to receive zoledronic acid versus no treatment. The cohort consisted of patients with a variety of tumour histologies including breast (16), lung (92), prostate (5), bladder (2), and renal (1). Patients were followed until the development of bone metastases.
After 12 and 18 months, respectively, 60% and 20% of patients in the zoledronic acid group were metastasis-free, compared with 10% and 5% in the control group (P=0.0002).
This small but provocative non-industry sponsored study suggests that bisphosphonates may be associated with a reduction in bone metastases in patients with cancer. Clearly larger, placebo-controlled, prospective randomized studies are needed in patients with androgen independent prostate cancer without bone metastases to address this important question.
Medical Oncology, vol. 22, no. 2, 195-201, 2005