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01.03.2016 | Original Article

Zoledronic acid for treatment of osteopenia and osteoporosis in women with primary breast cancer undergoing adjuvant aromatase inhibitor therapy: a 5-year follow-up

verfasst von: Neil Majithia, Pamela J. Atherton, Jacqueline M. Lafky, Nina Wagner-Johnston, Janet Olson, Shaker R. Dakhil, Edith A. Perez, Charles L. Loprinzi, Stephanie L. Hines

Erschienen in: Supportive Care in Cancer | Ausgabe 3/2016

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Abstract

Purpose

This study was designed to explore whether zoledronic acid could prevent expected loss of bone mineral density (BMD) in postmenopausal women with pre-existing osteopenia or osteoporosis who were initiating adjuvant letrozole therapy for primary breast cancer.

Methods

Between June 2006 and July 2007, 60 postmenopausal women with estrogen and/or progesterone receptor-positive breast cancer and a BMD T-score ≤−2.0 were enrolled. Participants received letrozole 2.5 mg and vitamin D 400 IU daily, calcium 500 mg twice daily, and zoledronic acid 4 mg every 6 months for a maximum of 5 years or until disease progression. BMD at the lumbar spine and femoral neck was recorded at the start of the study and annually for 5 years. Patients were evaluated for fractures every 6 months for the duration of the trial.

Results

After 5 years, mean BMD increased significantly by 11.6 % (p = 0.01) at the lumbar spine and by 8.8 % (p = 0.01) at combined sites. Femoral neck BMD increased by 4.2 %, although this was not significant (p = 0.23). At the end of the trial, BMDs were consistent with osteoporosis in 7 % and osteopenia in 36 % of the patients. A total of six fractures were reported after 417 individual assessments.

Conclusions

Zoledronic acid appears to prevent further bone loss in postmenopausal breast cancer patients with osteopenia and osteoporosis starting treatment with letrozole. These findings were maintained at 5 years and support concurrent initiation of bisphosphonate and aromatase inhibitor therapy in this high-risk population.

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Titel: Zoledronic acid for treatment of osteopenia and osteoporosis in women with primary breast cancer undergoing adjuvant aromatase inhibitor therapy: a 5-year follow-up
verfasst von: Neil Majithia
Pamela J. Atherton
Jacqueline M. Lafky
Nina Wagner-Johnston
Janet Olson
Shaker R. Dakhil
Edith A. Perez
Charles L. Loprinzi
Stephanie L. Hines
Publikationsdatum: 01.03.2016
Verlag: Springer Berlin Heidelberg
Erschienen in: Supportive Care in Cancer / Ausgabe 3/2016
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-015-2915-2

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Zoledronic acid for treatment of osteopenia and osteoporosis in women with primary breast cancer undergoing adjuvant aromatase inhibitor therapy: a 5-year follow-up