12月2日,，Cancer上刊登了一則研究論文"Retrospective analysis of antitumor effects of zoledronic acid in breast cancer patients with bone-only metastases",，該論文的主要研究人員認為唑來膦酸對于轉移性乳腺癌無抗腫瘤作用,。
通過對只有骨轉移的乳腺癌婦女服用唑來膦酸用以降低骨骼并發(fā)癥的進一步研究發(fā)現(xiàn)，治療既沒有延長無進展生存期,，也沒有延長總體生存期,。Naoto T. Ueno博士說到,，對于只有骨轉移的乳腺癌患者,，我們無法證明唑來膦酸的抗腫瘤作用,。
研究者注意到，臨床前研究表明雙磷酸鹽類有直接和間接的抗腫瘤作用,。他們希望只有骨轉移的乳腺癌患者,，一般具有相對較長的生存期，添加唑來膦酸或帕米膦酸到標準治療方案中后,，能夠得到更好的生存期,。
他們確認了10年中在MD Anderson看病的314名該類病人，當確認骨病時,，172名患者接受了唑來膦酸,，77名接受了帕米膦酸，65名沒有接受任何雙磷酸鹽,。
單因素分析中,，未使用雙磷酸鹽的無進展生存期優(yōu)于帕米膦酸（HR，0.57,；p=0.002）,。未使用雙磷酸鹽和唑來膦酸間無統(tǒng)計學差異（HR，0.72,；p=0.058）,，調整了一些諸如絕經(jīng)狀態(tài)和骨轉移數(shù)量的因素后，多因素分析顯示二者仍沒有統(tǒng)計學差異（HR,，0.80,；p=0.235）?？偵嫫谝餐瑯尤绱?，HR為1.34（p=0.192）。
目前,，使用唑來膦酸治療骨轉移是金標準,，因為可以顯著降低或預防骨骼相關事件，但是,，它不能延長生存和顯示任何抗腫瘤作用使得爭議仍在,。病人和醫(yī)生都應該對雙磷酸鹽治療的潛在益處有更加清楚的認識。（生物谷Bioon.com）
doi:10.1002/cncr.26512
PMC:
PMID:
Retrospective analysis of antitumor effects of zoledronic acid in breast cancer patients with bone-only metastases.
Niikura N, Liu J, Hayashi N, Palla SL, Tokuda Y, Hortobagyi GN, Ueno NT, Theriault RL.
BACKGROUND:
Bisphosphonates have been used successfully in the treatment of hypercalcemia and to reduce skeletal complications of bone metastasis, but have not been shown to prevent bone metastasis or to prolong survival time in metastatic breast cancer patients. The aim of this study was to determine whether the progression-free survival (PFS) and overall survival (OS) of patients with bone-only breast cancer metastasis differed based on whether patients received zoledronic acid, pamidronate, or no bisphosphonate upon diagnosis of their metastases.
PATIENTS AND METHODS:
We retrospectively identified 314 patients diagnosed with bone-only metastasis at the time of initial staging or who developed bone metastasis as the first recurrence site during follow-up from January 1, 1997 to December 31, 2008, at The MD Anderson Cancer Center. Univariate and multivariate Cox hazards models were used to assess the effects of each treatment on PFS and OS.
RESULTS:
Patients who had more than 1 bone metastasis and Eastern Cooperative Oncology Group (ECOG) performance status of 2 and 3 were more likely to receive zoledronic acid in this analysis. Compared with no bisphosphonate use, the use of zoledronic acid was not significantly associated with longer PFS (hazard ratio [HR] = 0.72, P = .058 in univariate analysis, and HR = 0.80, P = .235 in multivariate analysis) nor with longer OS (HR = 1.04, P = .863 in univariate analysis and HR = 1.34, P = .192 in multivariate analysis).
CONCLUSION:
Our study demonstrates that for patients with bone-only metastases, zoledronic acid did not prolong PFS or OS. In patients with bone-only metastasis, we could not demonstrate antitumor effects of zoledronic acid.
