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Efficacy of combined androgen blockade with zoledronic acid treatment in prostate cancer with bone metastasis: The ZABTON-PC (zoledronic acid/androgen blockade trial on prostate cancer) study

S. Ueno, A. Mizokami, T. Fukagai, N. Fujimoto, H. Oh-Oka, Y. Kondo, D. Arai, H. Ide, S. Horie, O. Ueki, K. Kawaguchi, M. Shimamura, M. Orito, T. Ishida, D. Ikeda, M. Namiki.

Anticancer Research, September 2013, Volume 33, no. 9, 3837-3844

Editor's comments:

Zoledronic acid is approved for the reduction of SREś in mCRPC patients. This small randomized study is at best hypothesis generating for moving the onset of Zoedronic acid therapy to the hormone-naïve mPCA setting. 

 

Abstract

Aim

Zoledronic acid (ZA) reduces the risk of skeletal-related events (SREs) in castration-resistant prostate cancer (CRPC) with bone metastasis and improves quality of life. It remains unclear when clinicians should initiate ZA treatment.

Patients and Methods

Hormone-naïve patients were randomized to a combined androgen blockade (CAB) group or CAB with ZA group (CAB-ZA) based on Gleason score (GS) or extent of disease. The primary end-point of the study was progression-free survival (PFS) and the secondary end-point was incidence of SREs and bone pain.

Results

Thirty-one and 29 patients among 60 enrolled patients were assigned to the CAB group and the CAB-ZA group, respectively. There was no significant difference in PFS between the two groups. Subgroup analyses revealed better PFS in the CAB-ZA group with GS ≥8 (p=0.021). Moreover, incidence of SREs, including bone pain, was lower in the CAB-ZA group (p=0.019).

Conclusion

CABZA treatment was found to improve PFS for patients with prostate cancer with high GS. CAB-ZA treatment could be recommended for treatment of patients with prostate cancer.

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