Among women treated with neoadjuvant (before surgery) chemotherapy for Stage II-III breast cancer, the addition of the bisphosphonate drug Zometa® (zoledronic acid) may reduce tumor cells in bone marrow. These results were published in Lancet Oncology.

Disseminated tumor cells (DTCs) refer to small numbers of cancer cells that have spread beyond the primary cancer site. DTCs can be found in the bone marrow of some patients with breast cancer, and are linked with an increased risk of distant metastasis and death. 

Bisphosphonates are a class of drugs used to prevent and treat osteoporosis and to reduce the risk of bone complications from bone metastases or multiple myeloma. Studies have suggested that in addition to their effects on bone, bisphosphonates may also have certain anticancer effects.

To evaluate the effect of the bisphosphonate drug Zometa on DTCs in bone marrow, researchers conducted a Phase II clinical trial among 120 patients with Stage II-III, newly diagnosed breast cancer. In addition to neoadjuvant chemotherapy, women were assigned to receive either Zometa or a placebo. 

  • After three months, DTCs were detected in 17 of 56 patients (30%) given Zometa, and 25 of 53 patients (47%) given a placebo. The difference between groups was not statistically significant, suggesting that it could have occurred by chance alone.
  • Zometa appeared to have the greatest effect among women who were initially free of DTCs. Among these women, 87% who were given Zometa remained free of DTCs at three months compared with 60% who were given a placebo.
  • The two study groups had similar disease-free survival at both 12 and 24 months.
  • There was one case of osteonecrosis (bone death) of the jaw among women treated with Zometa.  

This study provides some additional evidence that Zometa may have anticancer effects. 

Reference: Aft R, Naughton M, Trinkaus K et al. Effect of zoledronic acid on disseminated tumour cells in women with locally advanced breast cancer: an open label, randomised, phase 2 trial. Lancet Oncology[early online publication]. April 1, 2010.

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