Zoledronic acid for treatment of osteopenia and osteoporosis in women with primary breast cancer undergoing adjuvant aromatase inhibitor therapy: a 5-year follow-up

Neil Majithia, Pamela J. Atherton, Jacqueline M. Lafky, Nina Wagner-Johnston, Janet E Olson, Shaker R. Dakhil, Edith A. Perez, Charles Lawrence Loprinzi, Stephanie L. Hines

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Purpose: This study was designed to explore whether zoledronic acid could prevent expected loss of bone mineral density (BMD) in postmenopausal women with pre-existing osteopenia or osteoporosis who were initiating adjuvant letrozole therapy for primary breast cancer. Methods: Between June 2006 and July 2007, 60 postmenopausal women with estrogen and/or progesterone receptor-positive breast cancer and a BMD T-score ≤−2.0 were enrolled. Participants received letrozole 2.5 mg and vitamin D 400 IU daily, calcium 500 mg twice daily, and zoledronic acid 4 mg every 6 months for a maximum of 5 years or until disease progression. BMD at the lumbar spine and femoral neck was recorded at the start of the study and annually for 5 years. Patients were evaluated for fractures every 6 months for the duration of the trial. Results: After 5 years, mean BMD increased significantly by 11.6 % (p = 0.01) at the lumbar spine and by 8.8 % (p = 0.01) at combined sites. Femoral neck BMD increased by 4.2 %, although this was not significant (p = 0.23). At the end of the trial, BMDs were consistent with osteoporosis in 7 % and osteopenia in 36 % of the patients. A total of six fractures were reported after 417 individual assessments. Conclusions: Zoledronic acid appears to prevent further bone loss in postmenopausal breast cancer patients with osteopenia and osteoporosis starting treatment with letrozole. These findings were maintained at 5 years and support concurrent initiation of bisphosphonate and aromatase inhibitor therapy in this high-risk population.

Original languageEnglish (US)
Pages (from-to)1219-1226
Number of pages8
JournalSupportive Care in Cancer
Volume24
Issue number3
DOIs
StatePublished - Mar 1 2016

Fingerprint

zoledronic acid
letrozole
Aromatase Inhibitors
Metabolic Bone Diseases
Bone Density
Osteoporosis
Breast Neoplasms
Femur Neck
Spine
Therapeutics
Bone Neoplasms
Postmenopausal Osteoporosis
Diphosphonates
Progesterone Receptors
Vitamin D
Estrogen Receptors
Disease Progression
Calcium

Keywords

  • Breast cancer
  • Letrozole
  • Osteopenia
  • Osteoporosis
  • Zoledronic acid

ASJC Scopus subject areas

  • Oncology

Cite this

Zoledronic acid for treatment of osteopenia and osteoporosis in women with primary breast cancer undergoing adjuvant aromatase inhibitor therapy : a 5-year follow-up. / Majithia, Neil; Atherton, Pamela J.; Lafky, Jacqueline M.; Wagner-Johnston, Nina; Olson, Janet E; Dakhil, Shaker R.; Perez, Edith A.; Loprinzi, Charles Lawrence; Hines, Stephanie L.

In: Supportive Care in Cancer, Vol. 24, No. 3, 01.03.2016, p. 1219-1226.

Research output: Contribution to journalArticle

Majithia, Neil ; Atherton, Pamela J. ; Lafky, Jacqueline M. ; Wagner-Johnston, Nina ; Olson, Janet E ; Dakhil, Shaker R. ; Perez, Edith A. ; Loprinzi, Charles Lawrence ; Hines, Stephanie L. / Zoledronic acid for treatment of osteopenia and osteoporosis in women with primary breast cancer undergoing adjuvant aromatase inhibitor therapy : a 5-year follow-up. In: Supportive Care in Cancer. 2016 ; Vol. 24, No. 3. pp. 1219-1226.
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abstract = "Purpose: This study was designed to explore whether zoledronic acid could prevent expected loss of bone mineral density (BMD) in postmenopausal women with pre-existing osteopenia or osteoporosis who were initiating adjuvant letrozole therapy for primary breast cancer. Methods: Between June 2006 and July 2007, 60 postmenopausal women with estrogen and/or progesterone receptor-positive breast cancer and a BMD T-score ≤−2.0 were enrolled. Participants received letrozole 2.5 mg and vitamin D 400 IU daily, calcium 500 mg twice daily, and zoledronic acid 4 mg every 6 months for a maximum of 5 years or until disease progression. BMD at the lumbar spine and femoral neck was recorded at the start of the study and annually for 5 years. Patients were evaluated for fractures every 6 months for the duration of the trial. Results: After 5 years, mean BMD increased significantly by 11.6 {\%} (p = 0.01) at the lumbar spine and by 8.8 {\%} (p = 0.01) at combined sites. Femoral neck BMD increased by 4.2 {\%}, although this was not significant (p = 0.23). At the end of the trial, BMDs were consistent with osteoporosis in 7 {\%} and osteopenia in 36 {\%} of the patients. A total of six fractures were reported after 417 individual assessments. Conclusions: Zoledronic acid appears to prevent further bone loss in postmenopausal breast cancer patients with osteopenia and osteoporosis starting treatment with letrozole. These findings were maintained at 5 years and support concurrent initiation of bisphosphonate and aromatase inhibitor therapy in this high-risk population.",
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T1 - Zoledronic acid for treatment of osteopenia and osteoporosis in women with primary breast cancer undergoing adjuvant aromatase inhibitor therapy

T2 - a 5-year follow-up

AU - Majithia, Neil

AU - Atherton, Pamela J.

AU - Lafky, Jacqueline M.

AU - Wagner-Johnston, Nina

AU - Olson, Janet E

AU - Dakhil, Shaker R.

AU - Perez, Edith A.

AU - Loprinzi, Charles Lawrence

AU - Hines, Stephanie L.

PY - 2016/3/1

Y1 - 2016/3/1

N2 - Purpose: This study was designed to explore whether zoledronic acid could prevent expected loss of bone mineral density (BMD) in postmenopausal women with pre-existing osteopenia or osteoporosis who were initiating adjuvant letrozole therapy for primary breast cancer. Methods: Between June 2006 and July 2007, 60 postmenopausal women with estrogen and/or progesterone receptor-positive breast cancer and a BMD T-score ≤−2.0 were enrolled. Participants received letrozole 2.5 mg and vitamin D 400 IU daily, calcium 500 mg twice daily, and zoledronic acid 4 mg every 6 months for a maximum of 5 years or until disease progression. BMD at the lumbar spine and femoral neck was recorded at the start of the study and annually for 5 years. Patients were evaluated for fractures every 6 months for the duration of the trial. Results: After 5 years, mean BMD increased significantly by 11.6 % (p = 0.01) at the lumbar spine and by 8.8 % (p = 0.01) at combined sites. Femoral neck BMD increased by 4.2 %, although this was not significant (p = 0.23). At the end of the trial, BMDs were consistent with osteoporosis in 7 % and osteopenia in 36 % of the patients. A total of six fractures were reported after 417 individual assessments. Conclusions: Zoledronic acid appears to prevent further bone loss in postmenopausal breast cancer patients with osteopenia and osteoporosis starting treatment with letrozole. These findings were maintained at 5 years and support concurrent initiation of bisphosphonate and aromatase inhibitor therapy in this high-risk population.

AB - Purpose: This study was designed to explore whether zoledronic acid could prevent expected loss of bone mineral density (BMD) in postmenopausal women with pre-existing osteopenia or osteoporosis who were initiating adjuvant letrozole therapy for primary breast cancer. Methods: Between June 2006 and July 2007, 60 postmenopausal women with estrogen and/or progesterone receptor-positive breast cancer and a BMD T-score ≤−2.0 were enrolled. Participants received letrozole 2.5 mg and vitamin D 400 IU daily, calcium 500 mg twice daily, and zoledronic acid 4 mg every 6 months for a maximum of 5 years or until disease progression. BMD at the lumbar spine and femoral neck was recorded at the start of the study and annually for 5 years. Patients were evaluated for fractures every 6 months for the duration of the trial. Results: After 5 years, mean BMD increased significantly by 11.6 % (p = 0.01) at the lumbar spine and by 8.8 % (p = 0.01) at combined sites. Femoral neck BMD increased by 4.2 %, although this was not significant (p = 0.23). At the end of the trial, BMDs were consistent with osteoporosis in 7 % and osteopenia in 36 % of the patients. A total of six fractures were reported after 417 individual assessments. Conclusions: Zoledronic acid appears to prevent further bone loss in postmenopausal breast cancer patients with osteopenia and osteoporosis starting treatment with letrozole. These findings were maintained at 5 years and support concurrent initiation of bisphosphonate and aromatase inhibitor therapy in this high-risk population.

KW - Breast cancer

KW - Letrozole

KW - Osteopenia

KW - Osteoporosis

KW - Zoledronic acid

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