Oncology Medical News about advuvant breast cancer treatment;osteonecrosis of the jaw;bisphosphonates

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Osteonecrosis of the jaw and use of bisphosphonates in adjuvant breast cancer treatment: a metanalysis
Breast Cancer Research and Treatment, 06/16/09

Mauri D et al. - In a trial to estimate the cumulative randomized evidence for overall incidence of bisphosphonates-induced jaw osteonecrosis in adjuvant treatment of breast cancer, it was shown that use of zoledronic acid is associated with a higher number of events compared with no use, the osteonecrosis of the jaw during the adjuvant treatment of breast cancer is a rare event. At current dosage, adjuvant use of bisphosphonates in breast cancer treatment is safe.

Methods

Systematic review and meta-analysis of randomized clinical trials.
Trials were located through PubMed, ISI, Cochrane Library, and major cancer scientific meetings searches.
15 studies were identified reporting data on osteonecrosis of the jaw.
10,694 randomized women were included, of whom 5312 received bisphosphonates and 5382 received either placebo or no treatment.

Results

Osteonecrosis of the jaw was a rare event, occurring in 13 (0.24%) of the 5312 pts receiving bisphosphonates, and in 1 of 5382 pts in the control group.
All 13 events of osteonecrosis of the jaw reported among bisphosphonates arms occur in pts undergoing treatment with zoledronic acid (13/3,987, 0.33%).
No events of osteonecrosis of the jaw were reported among pts randomized to receive clodronate (n=669), pamidronate (n=460), risedronate (n=171), and ibandronate (n=25); however, these samples were too small to be able to rule out the condition.
Treatment with zoledronic acid was significantly associated with the occurrence of osteonecrosis of the jaw vs no use.

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