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

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

Research output: Contribution to journalReview article

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.

Original languageEnglish
Pages (from-to)68-75
Number of pages8
JournalCritical Reviews in Oncology/Hematology
Volume142
DOIs
Publication statusPublished - Oct 2019

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Keywords

  • AEs
  • Bone metastases
  • Breast
  • Meta-Analysis
  • Prostate
  • SMR
  • Solid tumors
  • Zoledronic acid

ASJC Scopus subject areas

  • Hematology
  • Oncology

Cite this

Santini, D., Galvano, A., Pantano, F., Incorvaia, L., Rizzo, S., Vincenzi, B., Castellana, L., Giuliana, G., Guadagni, F., Toia, F., Tonini, G., Russo, A., Badalamenti, G., & Bazan, V. (2019). 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. Critical Reviews in Oncology/Hematology, 142, 68-75. https://doi.org/10.1016/j.critrevonc.2019.07.013