Zometa news out of San Antonio....

Great news, thanks Kerry!

I was premenopausal at diagnosis though, been in chemopause since.The study shows the highest efficacy for menopausal at diagnosis, am I reading that right?

I hope some benefit is still obtained by those of us doing it after chemopause!!

Holy mackerel...thanks for the clarification Kerry. Oh my gosh, I just got teary eyed. Every ounce of hope helps. You have made my day!!

Great news is right!!! 

Thanks so much for posting Kerry!  I guess getting on my oncs back has really paid off! 

So excited to read this!!! Another drug in our aresnal..We need to keep bumping this so newbies read this and get it! I got zometa during chemo and am still on it! Who knows maybe metformin will be the next wonder drug for us! Interested to hear more on that as well!

No mention of POSTmenopausal women...ie those who were already past menopause when dx, and not put into menopause by ovarian supression.

I thought I read recently that the benefit was even greater for these women?

Thanks for posting this.

I'm going to be optimistic, and since I was peri when I was dx, I'll take the benefits of both studies.  I realize that makes not sense medically, but it makes me happy.

1athena1. The AZURE group also includes stages 1,2 and 3. I agree with you that both were well designed. I think lack of menstruation is key to the Zometa giving the most bang for the buck..

CIBD: Limit Bone Drug to Older Breast Cancer Patients

dec 5th 2011:

CHICAGO -- Only postmenopausal breast cancer patients benefit from adjuvant bisphosphonate therapy to prevent recurrence, according to updated results from an international randomized trial.

Women who were more than five years into menopause had a 25% improvement in survival free of recurrent invasive disease with zoledronic acid [Zometa] compared with placebo. In contrast, all other patients treated with the bisphosphonate had a 15% increase in the hazard, though it did not reach statistical significance.

The analysis showed that the lack of benefit in younger patients resulted from an increased incidence of extra-skeletal metastasis.

"These results do not support the routine use of zoledronic acid in unselected patients with early breast cancer, but do suggest a potential role in postmenopausal women," Robert E. Coleman, MD, of the University of Sheffield in England, said here at the International Conference on Cancer-Induced Bone Disease.

http://www.medpagetoday.com/MeetingCoverage/CIBD/30022 

I was just wondering the same thing Jackie.  My onc originally told me 3  years too, but now I am wondering of long term.

VR - another big difference is that in one trial, women also had chemotherapy and in the other they didn't. As far as I could tell there was no good protocol for "controlling" for chemotherapy. That's the trouble with even well designed statistical studies - strictly speaking, they show associations - no cause-effect relationships.

I think scientists need to get at the bottom of why AZURE and the Austrian study showed differences. I think the chemo variable was not analyzed and people gave too much attention to the "big news" about the Zometa maker withdrawing its application for approval for adjuvant treatment - they didn't delve into the methodological questions that could account for the apparently contradictory outcomes.

The jury is still out on a final answer for zometa alone, but since we all have to go with what little we know so far, I'm putting the question to my onc next week.

Diagnosis: 3/2009, IDC, 3cm, Stage IIb, Grade 3, 3/8 nodes, ER+/PR+, HER2-

If I remember correctly another difference was the frequency of Zometa doses. I believe that chemo patients in the AZURE trial had the Zometa with the chemo, and I think some had it every three weeks. I may be wrong. Whereas in the Austrian study the women had 4 mg every six months alone.  They either had no chemo OR had been treated with chemo previously.

VR - I don't understand a lot about this. Gnant's study was practice-changing and so was Coleman's for many of us. This is when the cancer research world gets on my nerves. Why is no one out there analyzing two well designed studies to explain these differences? How can the cancer world simply accept broad verdicts: Yes to Zometa for early stage pre-menopausal women in 2009 and a big NO in 2010.

This is the best example of why we need to be careful when we assume there is "science-based" facts versus alternative therapy in BC and that there is a simple line of divide.There is science-based fact, and then there is calendar year....lol!

Athena... I don't think it was a big No to premenopausal women. It was a No to those who menstruate.



Regarding evidence based medicine... Don't get me started again. Did you see the debate I started when I mentioned mortality endpoints as they relate to mammography screening for women 40-49??? I was also listening to breast cancer guru Larry Norton a few weeks ago, and wondered where he was getting his info from. He was soooo forthright about screening... And this was a few days after the British cancer czar decided to put together a task force to decide once and for all who should get what screening and when. I guess Larry Norton doesn't read The British Medical Journal....