Oral adjuvent Clodronate could improve survival

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Husband11
Husband11 Member Posts: 2,264
edited June 2014 in Clinical Trials, Research News, Podcasts, and Study Results

http://www.ejcancer.info/article/S0959-8049(13)00084-1/abstract

Oral adjuvant clodronate therapy could improve overall survival in early breast cancer: Results from an updated systematic review and meta-analysis

  • Jianhong Zhu
    • ,
  • Yayuan Zheng
    • ,
  • Zhikun Zhou

    Affiliations

    • Corresponding Author InformationCorresponding author: Address: Department of Pharmacy, Guangdong Medical College, No.1, Xincheng Dadao, Songshan Lake Science and Technology Industry Park, Dongguan, Guangdong Province, China. Tel.: +86 18928033088; fax: +86 769 22896599.
    email address

Department of Pharmacy, Guangdong Medical College, China

published online 01 March 2013.
Corrected Proof

Abstract 

Object

The aim of this study was to evaluate the effectiveness of clodronate in the adjuvant therapy of early breast cancer on patient survival.

Methods

We performed a literature search to identify studies that investigated the effects of clodronate treatment on early breast cancer. Random and fixed-effect meta-analytical models were used where indicated and between-study heterogeneity was assessed. The primary study end-points were overall survival. Secondary end-points were bone metastasis-free survival and non-skeletal metastasis (mainly visceral metastases) free survival.

Results

Four randomised controlled trials met the inclusion criteria. Risk ratio (95% confidence interval (CI)) of overall survival was 0.84 (0.56–1.26); risk ratio (95% CI) of bone metastasis-free survival was 0.77 (0.58–1.02); risk ratio (95% CI) of non-bone metastasis-free survival was 0.89 (0.61–1.30). Outcomes after sensitivity analysis were: risk ratio (95% CI) of overall survival was 0.71 (0.52–0.96); risk ratio (95% CI) of bone metastasis-free survival was 0.70 (0.56–0.86); risk ratio (95% CI) of non-bone metastasis-free survival was 0.76 (0.64–0.92).

Conclusion

Compared with the control arm, adjuvant treatment with clodronate may improve the overall survival, bone metastasis-free survival and non-bone metastasis-free (mainly visceral metastases) survival in patients with early breast cancer. However, further meta-analyses involving all known randomised trials with analysis of sub-groups by age or menopausal status, accessing original trial data, should be performed.

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Comments

  • Momine
    Momine Member Posts: 7,859
    edited March 2013

    Tim, do a check for studies done on zometa last year, investigating the same question. As far as I remember, the effect is greatest in women who are post-menopausal at DX.

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  • Husband11
    Husband11 Member Posts: 2,264
    edited March 2013

    Yes, I recall that was what came out of SABC last year regarding the menopausal status of patients on zolodronic acid (zometa) being key.  I was also under the impression that clodronate wasn't producing impressive results.  This analysis of existing data suggests otherwise.  I guess we must stay tuned for a definitive answer.

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  • weety
    weety Member Posts: 1,163
    edited March 2013

    Yeah, I had read the same thing somewhere last year--that it seemed the oral bisphosphanates were not getting promising results--only the IV ones like zometa.  Interesting to see the opposite now.

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  • Momine
    Momine Member Posts: 7,859
    edited March 2013

    Timothy, yes, the info is conflicting. My docs think that given my pre-meno status at DX, it is not worth it. The SEs with these drugs can be fairly serious and the benefit is, at best, ambiguous. Although I am stage 3, I have decided to skip them for now.

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