Immediate zoledronic acid treatment better than delayed in women receiving letrozole

the Oncology Nurse Advisor take:

Immediate treatment with zoledronic acid prevented bone loss compared with delayed treatment in postmenopausal women receiving letrozole for breast cancer and these differences were maintained at 5 years, a study published in the American Cancer Society journal Cancer has found.

Because it is known that postmenopausal women with breast cancer receiving aromatase inhibitors are at a higher risk for bone loss, researchers sought to compare the impact of immediate versus delayed treatment with zoledronic acid on bone loss.

Researchers analyzed data from 551 postmenopausal women who had received tamoxifen and were now receiving daily letrozole. Patients were randomly assigned 1:1 to upfront or delayed zoledronic acid 4mg IV every 6 months.

Results showed that the incidence of a 5% decrease in the total lumbar spine bone density was 10.2% and 41.2% in the upfront and delayed groups, respectively (P < 0.0001), suggesting that immediate treatment prevented bone loss moreso than delayed treatment at 5 years; however, researchers found that the incidence of osteoporosis or fractures was not significantly different between treatment arms.