A recent study conducted at the Southeast Louisiana Veterans Health Care System, New Orleans, LA, USA by the Section of Hematology and Medical Oncology, Tulane University School of Medicine, New Orleans, LA, evaluated the efficacy of the timely use of zoledronic acid (ZA) on clinical outcomes and health care utilization in men with bone-metastatic prostate cancer.

The subjects in the study, drawn from a Veterans Affairs database (01/2002-09/2009), all had prostate cancer with identified bone metastasis, but had no documented skeletal-related events (SREs) before the index date (that is, the first bone metastasis diagnosis date).

The men who received early ZA treatment, defined as having a ZA infusion after the index date and before any recorded SREs, were matched 1:1 on propensity score to men not treated with bisphosphonates (BPs). Risks of SREs, hospitalization and death during the 6-month post-index period were compared between matched cohorts using Kaplan-Meier analyses. Baseline characteristics were well balanced between the matched cohorts (n=73 per group).

1- The 6-month SRE-free survival and hospitalization-free survival were higher in the men receiving timely ZA than men without BP treatment (91.7 versus 71.5%, P< 0.01; 80.5 versus 66.3%, P=0.05, respectively).2- The 6-month mortality risk was significantly lower in the men treated with ZA versus those without BP treatment (4.3 versus 13.8%, P=0.04).The study concluded that timely ZA intervention in bone-metastatic prostate cancer patients was associated with significant reductions in 6-month risks of SREs, hospitalization and mortality, as compared with no BP treatment.A longer follow-up period would be greatly appreciated, but we can only take what has been provided. Despite the short follow-up period, the message remains clear. Once diagnosed with bone metastatic disease, men with advanced prostate cancer should insist that they be given treatment with zoledronic acid prior to developing any skeletal related events. Reference: Velde NV, Wu EQ, Guo A, Lu M, Yu AP, Sharma H, Liu J, Fan CP, Shi L., Prostate Cancer Prostatic Dis. 2010 Dec 21. Epub ahead of print, doi: 10.1038/pcan.2010.49 PubMed Abstract PMID: 21173792Joel T Nowak, M.A., M.S.W.