How do skeletal morbidity rate and special toxicities affect 12-week versus 4-week schedule zoledronic acid efficacy? A systematic review and a meta-analysis of randomized trials

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RESEARCH PRODUCT

How do skeletal morbidity rate and special toxicities affect 12-week versus 4-week schedule zoledronic acid efficacy? A systematic review and a meta-analysis of randomized trials

Antonio Russo Francesca Toia Sergio Rizzo Giuseppe Badalamenti Viviana Bazan Francesco Pantano Giuseppe Tonini Daniele Santini L. Castellana Antonio Galvano Lorena Incorvaia Bruno Vincenzi Fiorella Guadagni Giovanna Giuliana

subject

0301 basic medicine Male medicine.medical_specialty Meta-Analysi Bone Density Conservation Agent medicine.medical_treatment Bone Neoplasms Breast Neoplasms Bone Neoplasm Zoledronic Acid law.invention 03 medical and health sciences Prostate cancer 0302 clinical medicine Randomized controlled trial law Internal medicine medicine Humans Hypocalcaemia Breast Adverse effect Bone Density Conservation Agents Solid tumor business.industry Mortality rate Prostate Prostatic Neoplasms AE Hematology Bisphosphonate SMR medicine.disease Bone metastase 030104 developmental biology Zoledronic acid Treatment Outcome Oncology 030220 oncology & carcinogenesis Meta-analysis Prostatic Neoplasm Female business Breast Neoplasm medicine.drug Human

description

Abstract Background Zoledronic Acid is a bisphosphonate used in a 4-week schedule for the treatment of bone metastases. Some randomized trials supported its role also when administered every 12 weeks. Methods we performed a systematic review and a meta-analysis in order to evaluate the two different schedules in terms of skeletal morbidity rate (SMR), skeletal related events (SRE) and adverse events (AEs). Results our results showed a clinical difference favouring the 12-week schedule in terms of AEs (RR 1.17, 95% CI 1.06–1.29). No signifcant differences were found for SMR (RR 0.97, 95% CI 0.84–1.13) and SRE (RR 1.02, 95% CI 0.89–1.16). Conclusions Our findings support in clinical practice the 12-week schedule an alternative to the standard 4-week schedule in advanced breast and prostate cancer, in particular when the clinical comorbidities of the patients suggest a higher risk of renal failure or hypocalcaemia.

year	journal	country	edition	language
2019-10-01

10.1016/j.critrevonc.2019.07.013 http://hdl.handle.net/10447/407081