Boosting Bone Density and Extending Lives

Zometa increases bone density and decreases disease recurrence in breast cancer patients taking Femara

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Postmenopausal breast cancer patients are often prescribed aromatase inhibitors after primary treatment to reduce the risks of disease recurrence. These drugs can cause bone density loss, though.

Researchers have demonstrated a drug not only decreases this bone loss but has survival benefits.

Adding Zometa (zoledronic acid) to adjuvant (after surgery) therapy reduced breast cancer recurrence risks and increased bone mineral density. That's the latest data from a five-year trial.

"Ask if Zometa is appropriate for you."

Richard de Boer, M.D., of the Royal Melbourne Hospital in Victoria, Australia, reported this long-term data from the Zometa-Femara Adjuvant Synergy Trial (ZO-FAST) trial at the 2011 CTRC-AACR San Antonio Breast Cancer Symposium.

In this study, Dr. de Boer and colleagues examined if adding Zometa would improve the bone density and survival in women taking Femara (letrozole), an aromatase inhibitor. Zometa is an intravenous bisphosphonate.

Study participants included 1,065 patients who were about to start taking Femara. They were randomly assigned to  immediately receive Zometa every six months, or get the drug at a later time if and when they had a fracture or documented loss of bone mineral density.

After following patients for five years, researchers found women who received Zometa immediately had significantly less bone loss and also had 34 percent decrease is disease recurrence, compared to women who never took the drug.

Patients in the delayed group also benefited from the drug, seeing disease outcome improvements compared to women who never started the bisphosphonate, according to Dr. de Boer.

Adam M. Brufsky, M.D., Ph.D., professor of medicine at the University of Pittsburg School of Medicine and associate director of clinical investigation for the University of Pittsburgh Cancer Institute, told dailyRx, 

"This provides further compelling evidence that zoledronic acid (Zometa), given every six months as adjuvant therapy for breast cancer, not only protects against bone loss long-term in postmenopausal women receiving aromatase inhibitors, but also may improve disease free survival in these women as well."

"Taken together with the results released from a long-term overall survival analysis of [another study] ABSCG-12 (also presented at SABCS 2011), this suggests that twice yearly zoledronic acid should be considered as adjuvant therapy for postmenopausal women with breast cancer," Dr. Brufsky said.

Researchers say that additional studies are needed to define who would most likely benefit from adjuvant Zometa.

Reviewed by: 
Review Date: 
December 7, 2011
Last Updated:
December 7, 2011