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Effect Also Seen in Breast Cancer Patients

Dr. Gnant points out that the potential anticancer effects of bisphosphonates have also been reported in several studies of women who already have breast cancer, including one by his team. In that study, the Austrian Breast and Colorectal Cancer Study Group trial (n = 1803), and in ZO-FAST (Zometa-Femara Adjuvant Synergy Trial; n = 1065), the intravenous bisphosphonate zolendronic acid reduced cancer recurrence in bone and nonbone sites, including contralateral breast cancer, he notes.

There were also 2 previous studies of the oral bisphosphonate clodronate in women with breast cancer (total n = 1371) that showed a delay in the development of bone metastases and an improvement in disease-free and overall survival.

In addition, laboratory studies suggest that bisphosphonates have both direct and indirect anticancer effects, including effects on cancer cell apoptosis, inhibition of cancer cell adhesion and extravasation, inhibition of angiogenesis, and activation of immune cells with anticancer activity.

It is possible that these are a class effect of the bisphosphonates, Dr. Gnant writes.

All of these researchers and the editorialist urge further study in this field, because, as Dr. Gnant writes, "the potential implications would be far-reaching."

Dr. Gnant reports acting as a consultant/advisor, and/or receiving honoraria and/or research funding from AstraZeneca, Novartis, Pfizer, Roche, and Sanofi-Aventis. Dr. Chlebowski reports acting as a consultant/advisor for AstraZeneca, Novartis, Pfizer, Amgen, and Eli Lilly, and receiving honoraria from AstraZeneca, Novartis, and Amgen. Several coauthors report links with Novartis and Merck, and one coauthor holds stock in Merck. Dr. Rennert, Dr. Newcomb, and their colleagues have disclosed no relevant financial relationships.

J Clin Oncol. Published online June 21, 2010. Abstract, Abstract, Abstract

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