2017
DOI: 10.1111/ecc.12638
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Long-term safety of monthly zoledronic acid therapy beyond 1 year in patients with advanced cancer involving bone (LoTESS): A multicentre prospective phase 4 study

Abstract: Malignant bone disease can cause significant morbidity. Monthly zoledronic acid (ZOL) reduces skeletal complications; however, limited data are available regarding long‐term safety. We aimed to assess efficacy and safety of ZOL beyond 1 year of treatment. We prospectively evaluated 73 patients; breast cancer (n = 29), castrate‐resistant prostate cancer (n = 13), multiple myeloma (n = 31) from 2006 to 2008 in 19 cancer centres. All patients were diagnosed with bone disease and had completed 1–2 years of monthly… Show more

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Cited by 5 publications
(3 citation statements)
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References 26 publications
(96 reference statements)
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“…However, in patients with locally advanced breast cancer, ZOL combined with neoadjuvant chemotherapy had no significant effect on clinical outcomes in the overall cohort and, surprisingly, was also associated with increased extraosseous recurrence and shorter survival in patients with ER+/HER2- cancer who were less than 45 years of age [ 165 ]. The benefits of continuous monthly use of ZOL for at least 2 years outweighed the risks in patients with advanced bone tumors, including those related to breast cancer, prostate cancer, and multiple myeloma, according to follow-up studies [ 177 ]. In the palliative care setting, continuous second-line zoledronic acid treatment can significantly relieve pain, reduce the n-telopeptide (NTX) level, and exert a relevant palliative care effect on breast cancer patients with bone-related event or progressive bone metastases, after previous first-line bisphosphonate treatment [ 178 ].…”
Section: Therapies For Bone Metastasismentioning
confidence: 99%
“…However, in patients with locally advanced breast cancer, ZOL combined with neoadjuvant chemotherapy had no significant effect on clinical outcomes in the overall cohort and, surprisingly, was also associated with increased extraosseous recurrence and shorter survival in patients with ER+/HER2- cancer who were less than 45 years of age [ 165 ]. The benefits of continuous monthly use of ZOL for at least 2 years outweighed the risks in patients with advanced bone tumors, including those related to breast cancer, prostate cancer, and multiple myeloma, according to follow-up studies [ 177 ]. In the palliative care setting, continuous second-line zoledronic acid treatment can significantly relieve pain, reduce the n-telopeptide (NTX) level, and exert a relevant palliative care effect on breast cancer patients with bone-related event or progressive bone metastases, after previous first-line bisphosphonate treatment [ 178 ].…”
Section: Therapies For Bone Metastasismentioning
confidence: 99%
“…In PCa skeletal metastasis animal models, we and others have demonstrated anti-resorptive agents such as soluble receptor activator of NF-kappaB (sRANK) (Zhang et al 2003), osteoprotegerin (OPG) (Zhang et al 2001), and overexpression of OPG successfully diminished the tumor growth in bone (Corey et al 2005). In clinical application, ZA effectively reduces metastasis-related bone pain and skeletal complications in patients with metastatic PCa and breast cancer (Saad et al 2004), whereas more than 30% of patients will experience at least one skeletal complication after ZA therapy within a 2-year period, and ZA-unrelated serious events (Khalafallah et al 2018; Rosen et al 2004). Therefore, new effective treatments are urgently needed for patients with bone metastases and those at high risk of developing bone metastases.…”
Section: Introductionmentioning
confidence: 99%
“…Strontium-89 and bisphosphonates can also effectively alleviate bone pain. 2 Pain resulting from bone-destructive erosion, periosteal expansion under tension, or structural/mechanical instability may be managed with percutaneous cementoplasty techniques such as vertebroplasty, kyphoplasty, or osteoplasty. An epidural and intrathecal drug infusion system may also be deployed.…”
Section: Introductionmentioning
confidence: 99%