- Title
- Zoledronic acid (zoledronate) for postmenopausal women with early breast cancer receiving adjuvant letrozole (ZO-FAST study): final 60-month results
- Creator
- Coleman, R.; de Boer, R.; Frassoldati, A.; Campbell, I.; Paija, O.; Martin, N.; Modi, A.; Bundred, N.; Eidtmann, H.; Llombart, A.; Davidson, N.; Neven, P.; von Minckwitz, G.; Sleeboom, H. P.; Forbes, J.; Barrios, C.
- Relation
- Annals of Oncology Vol. 24, Issue 2, p. 398-405
- Publisher Link
- http://dx.doi.org/10.1093/annonc/mds277
- Publisher
- Oxford University Press
- Resource Type
- journal article
- Date
- 2013
- Description
- Background: Aromatase inhibitors are the preferred adjuvant endocrine therapy for the majority of postmenopausal women with hormone-responsive early breast cancer. Although generally more effective than tamoxifen, aromatase inhibitor therapy is associated with increased bone loss and fracture risk. Patients and methods: Postmenopausal women receiving adjuvant letrozole (2.5 mg/day for 5 years; N = 1065) were randomly assigned to immediate zoledronic acid (zoledronate) 4 mg every 6 months for 5 years, or delayed zoledronate (initiated for fracture or on-study bone mineral density [BMD] decrease). The primary end point was the change in lumbar spine BMD at 12 months. Lumbar spine and total hip BMD at subsequent follow-up, disease-free survival (DFS), and overall survival were assessed as secondary end points. Results: At 60 months (final analysis), the mean change in lumbar spine BMD was +4.3% with immediate zoledronate and −5.4% with delayed intervention (P < 0.0001). Immediate zoledronate reduced the risk of DFS events by 34% (hazard ratio [HR] = 0.66; P = 0.0375) with fewer local (0.9% versus 2.3%) and distant (5.5% versus 7.7%) recurrences versus delayed zoledronate. In the delayed group, delayed initiation of zoledronate substantially improved DFS versus no zoledronate (HR = 0.46; P = 0.0334). Conclusions: Immediate zoledronate in postmenopausal women receiving letrozole preserved BMD and is associated with improved DFS compared with letrozole alone.
- Subject
- anticancer; aromatase inhibitor; bone loss; breast cancer; survival; zoledronic acid
- Identifier
- http://hdl.handle.net/1959.13/1067346
- Identifier
- uon:18380
- Identifier
- ISSN:0923-7534
- Language
- eng
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