Economic evaluation of zoledronic acid for the prevention of osteoporotic fractures in postmenopausal women with early-stage breast cancer receiving aromatase inhibitors in the UK

Logman, Jfs; Heeg, Bart; Botteman, Marc; Kaura, S.; Hout, Ben A. van

doi:10.1093/annonc/mdp560

Cited by 17 publications

(6 citation statements)

References 35 publications

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“…Our results accord with the limited data published to date, including two industry-funded cu analyses 39,40 . Logman et al 39 performed a cu analysis of upfront and delayed za strategies for the prevention of adjuvant aromatase inhibitor-induced bone loss among postmenopausal women with breast cancer. Treatment with za consisted of 4 mg intravenous infusions every 6 months for up to 5 years during therapy with adjuvant aromatase inhibitor.…”

Section: Discussionsupporting

confidence: 90%

“…The study took the perspective of the United Kingdom's National Health Service and was based on interim results from the zo-fast study, considering only the fracture benefit of adjuvant za 41 . Compared with adjuvant treatment omitting za, upfront and delayed za resulted in icurs of £21,973 and £16,069 per qaly gained-both considered "highly acceptable" 39 . Lux et al 40 published a second cu analysis of adjuvant za from the perspective of the German health care system.…”

Section: Discussionmentioning

confidence: 99%

“…The results suggested that adjuvant za was less costly and more effective (that is, dominant) when incorporated into adjuvant treatment including ovarian suppression in women with endocrine-sensitive breast cancer. These industry-sponsored studies used efficacy data from single trials 39,40 ; by contrast, our study used pooled efficacy results from all trials of adjuvant za in the relevant setting.…”

Section: Discussionmentioning

confidence: 99%

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Cost–Utility of Adjuvant Zoledronic Acid in Patients with Breast Cancer and Low Estrogen Levels

et al. 2015

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Cost–Utility of Adjuvant Zoledronic Acid in Patients with Breast Cancer and Low Estrogen Levels

et al. 2015

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“…Administration of a combined array of therapeutic agents affecting different targets and displaying different toxicity profiles can lead to an improved therapeutic index [55]. While the combination therapy might be more expensive than mono-therapies, its benefits may include substantially reduced treatment failure, decreased mortality and as lower rate of drug resistance development [56]. In addition, combination therapy is also increasingly gaining in importance because it has numerous merits over conventional therapy.…”

Section: What Are Multi-target Inhibitors (Mtis) and Why Are They Nementioning

confidence: 99%

Use of Nanotechnology to Develop Multi-Drug Inhibitors for Cancer Therapy

Gowda¹,

Jones

Banerjee³

et al. 2013

J Nanomed Nanotechnol

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Therapeutic agents that inhibit a single target often cannot combat a multifactorial disease such as cancer. Thus, multi-target inhibitors (MTIs) are needed to circumvent complications such as the development of resistance. There are two predominant types of MTIs, (a) single drug inhibitor (SDIs) that affect multiple pathways simultaneously, and (b) combinatorial agents or multi-drug inhibitors (MDIs) that inhibit multiple pathways. Single agent multi-target kinase inhibitors are amongst the most prominent class of compounds belonging to the former, whereas the latter includes many different classes of combinatorial agents that have been used to achieve synergistic efficacy against cancer. Safe delivery and accumulation at the tumor site is of paramount importance for MTIs because inhibition of multiple key signaling pathways has the potential to lead to systemic toxicity. For this reason, the development of drug delivery mechanisms using nanotechnology is preferable in order to ensure that the MDIs accumulate in the tumor vasculature, thereby increasing efficacy and minimizing off-target and systemic side effects. This review will discuss how nanotechnology can be used for the development of MTIs for cancer therapy and also it concludes with a discussion of the future of nanoparticle-based MTIs as well as the continuing obstacles being faced during the development of these unique agents.’

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“…The timing of therapy (upfront vs. delayed) has been evaluated in several trials, among postmenopausal patients receiving aromatase inhibitors. The Zometa-Femara Adjuvant Synergy Trials (Z-FAST, ZO-FAST, and EZO-FAST) [ 38 , 39 , 40 , 41 , 42 , 43 , 44 , 46 , 47 ] and a National Cancer Institute (NCI) trial [ 48 ] compared zoledronate upfront ( i.e. , immediately) with delayed (i.e.…”

Section: Resultsmentioning

confidence: 99%

Bone Health in Patients with Breast Cancer: Recommendations from an Evidence-Based Canadian Guideline

Paterson

Shea‐Budgell

2013

JCM

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Bone loss is common in patients with breast cancer. Bone modifying agents (BMAs), such as bisphosphonates and denosumab, have been shown to reverse or stabilize bone loss and may be useful in the primary and metastatic settings. The purpose of this review is to provide clear evidence-based strategies for the management of bone loss and its symptoms in breast cancer. A systematic review of clinical trials and meta-analyses published between 1996 and 2012 was conducted of MEDLINE and EMBASE. Reference lists were hand-searched for additional publications. Recommendations were developed based on the best available evidence. Zoledronate, pamidronate, clodronate, and denosumab are recommended for metastatic breast cancer patients; however, no one agent can be recommended over another. Zoledronate or any oral bisphosphonate and denosumab should be considered in primary breast cancer patients who are postmenopausal on aromatase inhibitor therapy and have a high risk of fracture and/or a low bone mineral density and in premenopausal primary breast cancer patients who become amenorrheic after therapy. No one agent can be recommended over another. BMAs are not currently recommended as adjuvant therapy in primary breast cancer for the purpose of improving survival, although a major Early Breast Cancer Cooperative Trialists’ Group meta-analysis is underway which may impact future practice. Adverse events can be managed with appropriate supportive care.

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Economic evaluation of zoledronic acid for the prevention of osteoporotic fractures in postmenopausal women with early-stage breast cancer receiving aromatase inhibitors in the UK

Abstract: Both delayed and upfront therapy with ZOL for the prevention of AIBL and fractures in BC patients in the UK appear to result in highly acceptable cost-effectiveness ratios.

Cited by 17 publications

References 35 publications

Cost–Utility of Adjuvant Zoledronic Acid in Patients with Breast Cancer and Low Estrogen Levels

Cost–Utility of Adjuvant Zoledronic Acid in Patients with Breast Cancer and Low Estrogen Levels

Use of Nanotechnology to Develop Multi-Drug Inhibitors for Cancer Therapy

Bone Health in Patients with Breast Cancer: Recommendations from an Evidence-Based Canadian Guideline

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