Zoledronic acid: new hope for treatment of bone metastases

Research has found new hope in treating bone metastases from a wide range of cancers. Zoledronic acid, which belongs to a group of drugs called bisphosphonates, has been shown in clinical studies to be highly effictive in reducing bone-related problems across many tumour types.

The spread of cancer to bones (bone metastasis) is common, particularly in breast cancer, myeloma and prostate cancer. Bisphosphonates, among the other treatment options in managing bone metastases, have been used with the goal of treating, or, in some cases, preventing various problems associated with bone involvement such as high calcium level, fractures etc. Bisphosphonates prevent and control bone destruction. They are drugs that act by stopping the bone from being reabsorbed and also causing death of cells that cause bone destruction. Zoledronic acid is a highly potent member of the bisphosphonate family approved in more than 80 countries, used in the treatment of high calcium level, bone lesions from multiple myeloma, breast cancer, prostate cancer, lung cancer and other tumours. It is on the grounds of clinical trial evidence that zoledronic is said to be a potent bisphosphonate in reducing bone-related complications resulting from cancer spread to bones. These complications include fractures, compression of the spinal cord (nerves that run along the backbone), the need for radiation to the bone, and the need for surgery.In studies using animal models, zoledronic acid was reported to be the most potent bisphosphonate. It was also proven more superior than pamidronate, another member of the bisphosphonate group, in patients with bone involvement from breast cancer. It reduces the risk of bone problems by an addition of 20% compared to pamidronate. “Long-term follow-up data for 24 months confirmed that zoledronic acid was more effective than pamidronate in reducing the risk of bone-related complications in patients with bone metastases from breast cancer,” Dr. Rosen and colleagues reported in their large scale study involving 1648 patients. Also concluded in the same study was that zoledronic acid was equally effective as pamidronate in patients with multiple myeloma. When it comes to prostate cancer, treatment of bone spread using other bisphosphonates has only achieved temporary relief of bone pain and no significant reduction in the occurrence of bone-related events. Zoledronic acid, on the other hand, reduced this risk by 22%. The start of bone-related event was delayed and patients experience less pain with the use of the drug. For patients with renal cancer, some types of lung cancer, and other solid tumours, zoledronic acid works too. It has been proven effective in delaying the occurrence of bone-related problems. This further proves the efficacy of zoledronic acid in reducing bone complications across a wide range of tumour types.References:[1] Coleman RE. Metastatic bone disease: clinical features, pathophysiology and treatment strategies. Cancer Treat Rev 2001; 27: 165-76.[2] Rosen LS et al. Cancer 2003; 98: 1735-44. [3] Saad F et al. J Natl Cancer Inst 2004; 96(11): 879-82.