Zometa Confusion!
Help! When I was originally diagnosed 9/2010 my onc said Zometa once I started Arimidex. Fast forward almost three years and now she says studies are mixed so no Zometa now. When pressed she says I should do it if I want to err on the side of being aggressive. I have always erred on the side of being aggressive! If I'm willing to pay for it...why wouldn't I do it? Help!
Comments
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I was diagnosed in 2007, did chemo in 2008. Zometa information was just getting out and I asked my doctor. I'm with you on the aggressive side! He said OK, my insurance did cover 95% of the cost. I had 5-6 treatments 6 months apart. It was easy and I had no significant SE. I did request the infusion be done more slowly rather than 20 min usually done, 60 minutes instead.
My most recent DEXA scan shows some improvement in the early osteopenia I had before any chemo treatment and after 5 years on Armidex. That alone was worth the infustions.
Though the AZURe studies results are mixed I have NO regrets.
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I was diagnosed 12/2010. Started Arimidex 11/11 and 6 months later, started zometa - every 6 mos for 3 years, so 6 tx. My onc says it helps and it's worth doing. My question is why wouldn't you be aggresive? I've not had significant SE's either. I'm glad I'm doing it.
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I was part of a clinical trial. I was given zometa every month for two years. Then every 3 months for 2 1/2 years. It was a test to see if it prevented mets to the bone. My dentist is really concerned about changes he is seeing in my xrays. He has advised not to have any teeth pulled because my jaw could splinter and it would keep going. He said if I needed a tooth pulled, i would have to leave it to fall out on its own. He is concerned about jaw necrosis. That is a potential side effect of some zometa. -
Bisphosphonates, such as Zometa, Aredia and other drugs in that class are bone strengtheners, not ant-cancer drugs. There had been some early evidence that they did offer protection to the bones against bone mets. Current evidence has shown this not to be true. Additionally, the chances of developing osteonecrosis of the jaw and femur fractures goes up the longer one uses it. My onc is not longer recommending these drugs for more than 1-2 years. I had Aredia monthly for one year and every 3 months for the second year. Will have my last infusion at the end of this month. More or aggressive is not always better. -
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3086108/
Regarding the AZURE trial at San Antonio Breast Cancer Symposium:
"Dr. Coleman said, “Clearly, our results are very different from ABCSG-12, but actually these two populations are not the same.”
He pointed out that in terms of the host, AZURE patients were treated in a high-estrogen environment and ABCSG-12 patients were treated in a low-estrogen environment. That difference was reflected in a further prespecified analysis of disease-free survival from AZURE based on menopausal status."
The premenopausal women in the ABCSG-12 were given ovarian suppression with goserelin. In the AZURE trial, ovarian suppression was not allowed. So at least in the premenopausal group we are not comparing "apples to apples." Further investigation is warranted.
I included the link so you can read it yourself. If am I misunderstanding the information from the article, please let me know. -
I thought the difference in efficacy of the trials is mainly age and menopausal status. That women under age of 40 they didn't see any significant results but women over 40 and post meno better results. But I could have just picked out what I wanted to when reading as I am taking zometa off trial for prevention purposes and really hoping there is a positive outcome -
I think the ABCSG-12 trial did show that. All these women were given goserelin for ovarian suppression basically making them menopausal.
I wonder why 40 is the magic age. I'm 48, taking tamoxifen, and getting ovarian suppression. So maybe that's why my doctor is giving me Zometa.
I think the AZURE trial only showed benefit for women who were at least 5 years post menopausal. However, none of the premenopausal women in this trial had ovarian suppression.
So then it seems the women between age 40 and those five years post menopausal are different between the studies? In the first study they were given ovarian suppression and not in the second
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