22 maart 2005: Bron: J Natl Cancer Inst. 2002 Oct 2;94(19):1458-68.

Al eerder hadden we deze studie gepubliceerd maar kan die niet zo snel vinden op de site en hoort ook bij alle informatie over Zometa - Zoledronic Acid te staan. Dus hierbij nogmaals het abstract en verwijzingen naar discussie hierover in grote medische tijdschriften over Zometa en effect bij prostaatkankerpatiënten.

Comment in:
BJU Int. 2003 Apr;91(6):464-5.
J Natl Cancer Inst. 2002 Oct 2;94(19):1422-3.
J Natl Cancer Inst. 2003 Aug 6;95(15):1174-5; author reply 1175.
J Natl Cancer Inst. 2003 Feb 19;95(4):332-3; author reply 333-4.
J Natl Cancer Inst. 2003 Feb 19;95(4):332; author reply 333-4.
J Natl Cancer Inst. 2003 Feb 19;95(4):332; author reply 333-4.
J Natl Cancer Inst. 2004 Aug 4;96(15):1183; author reply 1183-1184.
J Natl Cancer Inst. 2004 Oct 6;96(19):1480; author reply 1480-1.
J Natl Cancer Inst. 2005 Feb 2;97(3):235-6.

A randomized, placebo-controlled trial of zoledronic acid in patients with hormone-refractory metastatic prostate carcinoma.

Saad F, Gleason DM, Murray R, Tchekmedyian S, Venner P, Lacombe L, Chin JL, Vinholes JJ, Goas JA, Chen B; Zoledronic Acid Prostate Cancer Study Group. Uro-Oncology Clinic, Centre Hospitalier de l'Universite de Montreal, Hopital Notre-Dame, Montreal, Quebec, Canada. fred.saad@ssss.gouv.qc.ca

BACKGROUND: Bone metastases are a common cause of morbidity in patients with prostate carcinoma. We studied the effect of a new bisphosphonate, zoledronic acid, which blocks bone destruction, on skeletal complications in prostate cancer patients with bone metastases. METHODS: Patients with hormone-refractory prostate cancer and a history of bone metastases were randomly assigned to a double-blind treatment regimen of intravenous zoledronic acid at 4 mg (N = 214), zoledronic acid at 8 mg (subsequently reduced to 4 mg; 8/4) (N = 221), or placebo (N = 208) every 3 weeks for 15 months. Proportions of patients with skeletal-related events, time to the first skeletal-related event, skeletal morbidity rate, pain and analgesic scores, disease progression, and safety were assessed. All statistical tests were two-sided.

RESULTS: Approximately 38% of patients who received zoledronic acid at 4 mg, 28% who received zoledronic acid at 8/4 mg, and 31% who received placebo completed the study. A greater proportion of patients who received placebo had skeletal-related events than those who received zoledronic acid at 4 mg (44.2% versus 33.2%; difference = -11.0%, 95% confidence interval = -20.3% to -1.8%; P =.021) or those who received zoledronic acid at 8/4 mg (38.5%; difference versus placebo = -5.8%, 95% CI = -15.1% to 3.6%; P =.222). Median time to first skeletal-related event was 321 days for patients who received placebo, was not reached for patients who received zoledronic acid at 4 mg (P =.011 versus placebo), and was 363 days for those who received zoledronic acid at 8/4 mg (P =.491 versus placebo). Compared with urinary markers in patients who received placebo, urinary markers of bone resorption were statistically significantly decreased in patients who received zoledronic acid at either dose (P =.001). Pain and analgesic scores increased more in patients who received placebo than in patients who received zoledronic acid, but there were no differences in disease progression, performance status, or quality-of-life scores among the groups. Zoledronic acid at 4 mg given as a 15-minute infusion was well tolerated, but the 8-mg dose was associated with renal function deterioration.

CONCLUSION: Zoledronic acid at 4 mg reduced skeletal-related events in prostate cancer patients with bone metastases. PMID: 12359855 [PubMed - indexed for MEDLINE]

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