Adjuvant Zoledronate Therapy for Women With Breast Cancer—Effective Treatment or Fool’s Gold?

Mené sur 2 987 patientes atteintes d'un cancer du sein de stade précoce (âge médian : 53 ans), cet essai de phase III évalue l'efficacité, du point de vue de la survie sans maladie et de la survie globale, et les événements indésirables osseux d'un traitement adjuvant par bisphosphonate en fonction de sa durée (2 ans ou 5 ans)

Résumé en anglais

In this issue of JAMA Oncology, Friedl and colleagues report results of the SUCCESS-A trial in which 2987 women were randomized to receive zoledronate either for 5 years (4 mg intravenously every 3 months for 2 years, then every 6 months for 3 years) or for 2 years (4 mg intravenously every 3 months). Eligible women had invasive breast cancer at high risk of recurrence: either node-positive or node-negative with a tumor size greater than 2 cm, histological grade 3, negative hormone-receptor status, or in women 35 years or younger. Both premenopausal and postmenopausal women participated; they received adjuvant chemotherapy, and zoledronate treatment was started after its completion. Women with hormone receptor–positive cancer received endocrine treatment for 5 years. Analysis of SUCCESS-A at a median of 5 years after initiation of zoledronate showed no significant difference in its primary end point of disease-free survival (DFS) for women receiving 5-year or 2-year adjuvant zoledronate (hazard ratio [HR], 0.97; 95% CI, 0.76-1.25; P = .83). There was also no statistically significant difference in overall survival (OS), distant disease-free survival, and bone recurrence–free survival. There were no discernable trends for subgroups defined by menopausal or hormone-receptor status.