双膦酸盐+内分泌治疗减少绝经后早期乳腺癌复发

2011-12-09 MedSci MedSci原创

    ZO-FAST研究最新数据显示,唑来膦酸联合辅助内分泌治疗提高绝经后早期激素受体阳性乳腺癌患者骨密度并降低复发风险。   在12月6-10日举行的圣安东尼奥乳腺癌大会上,澳大利亚皇家墨尔本医院的Richard de Boer博士报告了上述结果。   De Boer及其同事们发现,在辅助内分泌治疗基础上加用唑来膦酸可减少骨密度丧

    ZO-FAST研究最新数据显示,唑来膦酸联合辅助内分泌治疗提高绝经后早期激素受体阳性乳腺癌患者骨密度并降低复发风险。

  在12月6-10日举行的圣安东尼奥乳腺癌大会上,澳大利亚皇家墨尔本医院的Richard de Boer博士报告了上述结果。

  De Boer及其同事们发现,在辅助内分泌治疗基础上加用唑来膦酸可减少骨密度丧失,并改善生存转归。

  他在2010年的圣安东尼奥乳腺癌大会上报告的ZO-FAST初步结果表明,早期应用唑来膦酸可显著提高骨密度,并延长无病生存期。在本次大会上,他报告了该研究长期结果以及绝经状态对无病生存的影响。

  该研究纳入了1065例即将开始使用来曲唑的患者,随机将其分为立即每6个月1个周期使用唑来膦酸治疗组或延迟使用唑来膦酸治疗组。

  随访60个月后,“该研究成功达到主要终点,早期使用唑来膦酸显著降低腰椎和髋部骨密度,” De Boer说,“无病生存期延长的次要终点也被达到,早期应用唑来膦酸的患者疾病复发率降低34%。”

  研究者根据诊断乳腺癌时的绝经状态进行了探索性亚组分析。结果显示,诊断时已经绝经的女性立即接受唑来膦酸治疗可使疾病复发率降低29%,并使总生存率升高35%。

  “此外,延迟使用唑来膦酸组患者也显示获益,与从未使用双膦酸盐的患者相比,其疾病转归改善,” De Boer说。

  “即将开始来曲唑治疗的绝经后激素受体阳性乳腺癌患者可考虑联合唑来膦酸治疗,这不但可以维持骨密度,而且可降低疾病复发风险,” De Boer说。

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Llombart A, Frassoldati A, Paija O, Sleeboom HP, Jerusalem G, Mebis J, Deleu I, Miller J, Schenk N, Neven P.Immediate Administration of Zoledronic Acid Reduces Aromatase Inhibitor-Associated Bone Loss in Postmenopausal Women With Early Breast Cancer: 12-Month Analysis of the E-ZO-FAST Trial. Clin Breast Cancer. 2011 Oct 19

Eidtmann H, de Boer R, Bundred N, Llombart-Cussac A, Davidson N, Neven P, von Minckwitz G, Miller J, Schenk N, Coleman R.Efficacy of zoledronic acid in postmenopausal women with early breast cancer receiving adjuvant letrozole: 36-month results of the ZO-FAST Study.Ann Oncol. 2010 Nov;21(11):2188-94.

Brufsky A, Bundred N, Coleman R, Lambert-Falls R, Mena R, Hadji P, Jin L, Schenk N, Ericson S, Perez EA; Z-FAST and ZO-FAST Study Groups.Integrated analysis of zoledronic acid for prevention of aromatase inhibitor-associated bone loss in postmenopausal women with early breast cancer receiving adjuvant letrozole.Oncologist. 2008 May;13(5):503-14

Gnant M.Intravenous bisphosphonates for breast cancer: Impact on patient outcomes and scientific concepts. Breast Dis. 2011 Dec 5

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    2012-01-27 gwc392
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    2011-12-11 zxxiang

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