BoHFAB. The impact of adjuvant zoledronate therapy on bone health in postmenopausal patients with early breast cancer: Young Investigator Award Winners and Outstanding Abstract Award Winners in Program Order.

Brown, J.; Paggiosi, M.; Rathbone, E.; Dodwell, D.; Cameron, D.; Gregory, W.; Eastell, R.; Coleman, R.

BoHFAB. The impact of adjuvant zoledronate therapy on bone health in postmenopausal patients with early breast cancer: Young Investigator Award Winners and Outstanding Abstract Award Winners in Program Order.

All Authors

Brown, J.

Paggiosi, M.

Rathbone, E.

Dodwell, D.

Cameron, D.

Gregory, W.

Eastell, R.

Coleman, R.

LTHT Author

Dodwell, David

LTHT Department

Oncology
Leeds Cancer Centre
Clinical Oncology

Publication Date

2024

Item Type

Conference Abstract

Abstract

Background. Adjuvant bisphosphonates, usually given over 3-5 years, have become widely used in post-menopausal patients with intermediate-to-high risk, early breast cancer with the aim of reducing distant recurrence. One of the main trials to underpin the adoption of adjuvant bisphosphonates was the randomised Phase III AZURE trial in which 3,300 patients with stage II/III breast cancer received zoledronate plus standard therapy or standard therapy alone for 5 years, with a further 5-year follow-up. Purpose. To evaluate the impact of adjuvant zoledronate on bone health of a sub-group of AZURE patients over the 5-year follow-up period. Methods. 229 women (122 zoledronate/107 control), who had completed the AZURE trial within the previous 3 months, were recruited from 20 UK sites. BMD (lumbar spine, femoral neck, total hip) and bone turnover biomarkers, urinary alphaCTX, betaCTX (relative to creatinine), serum PINP, TRACP5b, were assessed at sub-study entry and thereafter at 12, 24 months (60 months for BMD). Results. Mean BMD (+/-SD) at study entry in zoledronate and control arms respectively was: lumbar spine 1123 (+/-201) and 985 (+/-182) mg/cm2 (p <.0001); femoral neck 847 (+/-130) and 782 ((+/-120) mg/cm2 (p <.0001). The BMD differences at baseline persisted throughout the 5-year follow-up with little change in mean BMD (see figure). Baseline median (IQR) biomarkers were all significantly (p <.001)) suppressed in the zoledronate arm (see Table) and remained suppressed, though with some offset at 24 months. Conclusions. Adjuvant zoledronate results in a sustained increase in BMD and suppression of bone turnover. Most patients after receiving adjuvant bisphosphonates are unlikely to require additional bone-targeted therapy to prevent bone loss. [Formula presented]