1146 POSTER Cost-effectiveness of zoledronic acid in the prevention of fractures in postmenopausal women with early breast cancer receiving aromatase inhibitor: Application to the United Kingdom

Logman, F.; Heeg, Bart; Botteman, MF; Marfatia, Aditya; Hout, Ben A. van

doi:10.1016/s1359-6349(07)70665-1

Cited by 8 publications

(3 citation statements)

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“…A recent health economic analysis of the Z-FAST trial, based on practice and costs within the United Kingdom, demonstrated that ZA is cost effective in preventing fractures in women with early breast cancer receiving AI therapy,54 particularly when treatment is initiated before bone loss occurs. However, the conclusions were limited by the lack of fracture data from Z-FAST.…”

Section: Management Strategies To Prevent Cancer Therapy-induced Bonementioning

confidence: 99%

Metastasis and bone loss: Advancing treatment and prevention

Coleman

Lipton

Roodman

et al. 2010

Cancer Treatment Reviews

119

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Tumor metastasis to the skeleton affects over 400,000 individuals in the United States annually, more than any other site of metastasis, including significant proportions of patients with breast, prostate, lung and other solid tumors. Research on the bone microenvironment and its role in metastasis suggests a complex role in tumor growth. Parallel preclinical and clinical investigations into the role of adjuvant bone-targeted agents in preventing metastasis and avoiding cancer therapy-induced bone loss have recently reported exciting and intriguing results. A multidisciplinary consensus conference convened to review recent progress in basic and clinical research, assess gaps in current knowledge and prioritize recommendations to advance research over the next 5 years. The program addressed three topics: advancing understanding of metastasis prevention in the context of bone pathophysiology; developing therapeutic approaches to prevent metastasis and defining strategies to prevent cancer therapy-induced bone loss. Several priorities were identified: (1) further investigate the effects of bone-targeted therapies on tumor and immune cell interactions within the bone microenvironment; (2) utilize and further develop preclinical models to study combination therapies; (3) conduct clinical studies of bone-targeted therapies with radiation and chemotherapy across a range of solid tumors; (4) develop biomarkers to identify patients most likely to benefit from bone-targeted therapies; (5) educate physicians on bone loss and fracture risk; (6) define optimal endpoints and new measures of efficacy for future clinical trials; and (7) define the optimum type, dose and schedule of adjuvant bone-targeted therapy.

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Section: Management Strategies To Prevent Cancer Therapy-induced Bonementioning

confidence: 99%

Metastasis and bone loss: Advancing treatment and prevention

Coleman

Lipton

Roodman

et al. 2010

Cancer Treatment Reviews

119

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“…intravenous zoledronic acid) is cost-effective in women receiving AIs for early breast cancer with an estimated incremental cost-effectiveness ratios (ICERs) that ranged from £17,900 to £30,000 per quality-adjusted life-year (QALY) gained. 129 In contrast, a recent cost-effectiveness analysis conducted by the author demonstrated that the use of upfront bisphosphonate (i.e. oral risedronate) is not reasonably cost-effective with an estimated ICER of $195,300 per QALY gained.…”

Section: Clinical Practice Guidelines For Cancer Treatment-induced Bomentioning

confidence: 96%

Pharmacotherapy Options in Cancer Treatment-induced Bone Loss: Focus on Bisphosphonates

Ito

2009

Clinical Medicine. Therapeutics

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Bone loss and its associated risk of fracture is a serious long-term health issue for breast cancer and prostate cancer survivors. Hormone ablation therapy, in particular aromatase inhibitors (AIs) for breast cancer and androgen deprivation therapy (ADT) for prostate cancer, causes marked reduction in circulating estrogen or testosterone levels, resulting in increased bone resorption, decreased bone mineral density (BMD), and an increased risk of fragility fracture. In several clinical trials with small sample sizes and short follow-up periods, oral and intravenous bisphosphonates have been shown to improve BMD, but not actual fracture rates, in cancer patients on hormone ablation therapy. A number of professional organizations and expert panels recommend the use of bisphosphonates for selected patients at risk. Although bisphosphonates are generally well tolerated, physicians should be aware of safety concerns, including the risk of osteonecrosis of the jaw. With the growing number of older breast and prostate cancer survivors, additional research is needed to characterize patients who would benefit from pharmacotherapy and optimize strategies to prevent cancer treatment-induced bone loss.

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“…However, recently, expert panels recognizing the necessity to address accelerated bone loss in these at-risk populations and taking into account the negative impact of fractures on patient independence and QoL, combining the large body of evidences on prevention of CTIBL, mainly using zoledronic acid, recommend that all patients treated with endocrine adjuvant therapy should be evaluated for the risk of CTIBL and eventually treated with BPs [72,73]. Recent analysis of the Z-FAST trial demonstrates that zoledronic acid is cost-effective in the prevention of fractures in women with early breast cancer treated with AI, particularly when the treatment is started before bone loss has occurred [180].…”

Section: Expert Opinionmentioning

confidence: 99%

Emerging drugs for the management of cancer treatment induced bone loss

Bertoldo

Pancheri²,

Zenari³

et al. 2010

Expert Opinion on Emerging Drugs

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The very high rate of bone loss and the high incidence of fractures indicate that cancer patients at risk of CTIBL need to be carefully monitored and stratified for fracture risk. Although there is a strong evidence of efficacy in prevention of bone loss and reduction of fracture risk for many drugs approved for postmenopausal osteoporosis (PMO) and male osteoporosis, for CTIBL there are actually no drugs approved for this indication.

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1146 POSTER Cost-effectiveness of zoledronic acid in the prevention of fractures in postmenopausal women with early breast cancer receiving aromatase inhibitor: Application to the United Kingdom

Cited by 8 publications

References 0 publications

Metastasis and bone loss: Advancing treatment and prevention

Metastasis and bone loss: Advancing treatment and prevention

Pharmacotherapy Options in Cancer Treatment-induced Bone Loss: Focus on Bisphosphonates

Emerging drugs for the management of cancer treatment induced bone loss

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