Influence of zoledronic acid on disseminated tumor cells in primary breast cancer patients

• Published in: Annals of oncology Vol. 23; no. 9; pp. 2271 - 2277
• Main Authors: Solomayer, E.-F., Gebauer, G., Hirnle, P., Janni, W., Lück, H.-J., Becker, S., Huober, J., Krämer, B., Wackwitz, B., Wallwiener, D., Fehm, T.
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01.09.2012; Oxford University Press
• Subjects: Adult; Aged; Antineoplastic agents; Antineoplastic Agents - adverse effects; Antineoplastic Agents - pharmacology; Antineoplastic Agents - therapeutic use; Arthralgia - chemically induced; Biological and medical sciences; Bone Marrow Cells - pathology; Bone Neoplasms - prevention & control; Bone Neoplasms - secondary; breast cancer; Breast Neoplasms - drug therapy; Breast Neoplasms - pathology; Diphosphonates - adverse effects; Diphosphonates - pharmacology; Diphosphonates - therapeutic use; disseminated tumor cells; Female; Gynecology. Andrology. Obstetrics; Humans; Imidazoles - adverse effects; Imidazoles - pharmacology; Imidazoles - therapeutic use; Mammary gland diseases; Medical sciences; metastasis; Middle Aged; Neoplasm Recurrence, Local - prevention & control; Neoplastic Cells, Circulating - pathology; Pharmacology. Drug treatments; recurrence; Treatment Outcome; Tumors; Zoledronic Acid; recurrence; disseminated tumor cells; breast cancer; metastasis; zoledronic acid; Antineoplastic agent; Human; Recurrence; Relapse; Antiosteoporotic; Breast disease; Antiresorptive agent; Diphosphonic acid derivatives; Patient; Breast cancer; Malignant tumor; Metastasis; Bisphosphonates; Mammary gland diseases; Zoledronic acid; Disseminated; Tumor cell; Cancer; Primary cancer
• ISSN: 0923-7534; 1569-8041
• DOI: 10.1093/annonc/mdr612

The presence of disseminated tumor cells (DTCs) in bone marrow of patients with early breast cancer (EBC) has been correlated with increased risk of metastatic disease or locoregional relapse. Zoledronic acid (ZOL) treatment has reduced DTCs in the bone marrow of patients with EBC in several studies. This controlled study sought to confirm these observations. Patients with EBC and DTC-positive bone marrow were randomized (N=96) to treatment with ZOL plus adjuvant systemic therapy or adjuvant systemic therapy alone. The change in DTC numbers at 12 months versus baseline was measured. DTC-positive patients treated with ZOL were more likely to become DTC-negative after 12 months of treatment compared with the controls (67% versus 35%; P=0.009). At 12 months, DTC counts decreased to a mean of 0.5±0.8 DTCs in the ZOL group and to 0.9±0.8 DTCs in the control group. In addition, ZOL was generally well tolerated. Treatment with ZOL improves elimination of DTCs. Further studies are needed to determine whether the reduction in DTCs by ZOL provides clinical benefit.