培训资料乳腺癌临床研究进展课件.pptVIP

* * * * * Adjuvant clodronate trials in breast cancer have produced conflicting results Two 2-year trials in patients with early breast cancer (N = 1,371) reported encouraging results1-3 Delay in bone metastases Increased disease-free survival in 1 trial Increased overall survival in both trials Long-term (10-year) trial data in women with early breast cancer (N = 299) demonstrated no significant treatment efficacy4 No significant skeletal effect No effect on disease-free or overall survival A meta-analysis of clodronate in the adjuvant setting demonstrated that there was no significant improvement in survival with clodronate versus no treatment5 References Diel IJ, Solomayer EF, Costa SD, et al. Reduction in new metastases in breast cancer with adjuvant clodronate treatment. N Engl J Med. 1998;339:357-363. Diel IJ, Solomayer E, Gollan C et al. Bisphosphonates in the reduction of metastases in breast cancer – results of the extended follow-up of the first study population. Proc Am Soc Clin Oncol 2000;19:82a. Powles T, Paterson A, McCloskey E, et al. Reduction in bone relapse and improved survival with oral clodronate for adjuvant treatment of operable breast cancer [ISRCT. Breast Cancer Res. 2006;8:R13. Saarto T, Vehmanen L, Virkkunen P, et al. Ten-year follow-up of a randomized controlled trial of adjuvant clodronate treatment in node-positive breast cancer patients. Acta Oncol. 2004;43:650-656. Ha TC and Li H. Meta-analysis of clodronate and breast cancer survival. Br J Cancer. 2007;96:1796-1801. * * * * * * * Adding ZOL to endocrine therapy significantly improved DFS compared with endocrine therapy alone at 47.8 months’ median follow-up (845/899 [94%] vs 821/904 [90.8%]; P = .01) The absolute 3.2% improvement in DFS in patients who received ZOL represents a 36% relative reduction in terms of DFS risk compared with endocrine therapy alone (P = .01) * * * Patients treated with ZOL (n = 899) experienced only 54 events compared with 83 events in pat