The Experts below are selected from a list of 51 Experts worldwide ranked by ideXlab platform

Diana Ritchie - One of the best experts on this subject based on the ideXlab platform.

  • breast Cancer Adjuvant Therapy with zoledronic acid
    The New England Journal of Medicine, 2011
    Co-Authors: Robert E. Coleman, Helen Marshall, David Cameron, David Dodwell, Roger Burkinshaw, M. Keane, Stephen Houston, Robert Grieve, Peter Barrettlee, Diana Ritchie
    Abstract:

    A b s t r ac t Background Data suggest that the Adjuvant use of bisphosphonates reduces rates of recurrence and death in patients with early-stage breast Cancer. We conducted a study to determine whether treatment with zoledronic acid, in addition to standard Adjuvant Therapy, would improve disease outcomes in such patients. Methods In this open-label phase 3 study, we randomly assigned 3360 patients to receive standard Adjuvant systemic Therapy either with or without zoledronic acid. The zoledronic acid was administered every 3 to 4 weeks for 6 doses and then every 3 to 6 months to complete 5 years of treatment. The primary end point of the study was disease-free survival. A second interim analysis revealed that a prespecified boundary for lack of benefit had been crossed. Results At a median follow-up of 59 months, there was no significant between-group difference in the primary end point, with a rate of disease-free survival of 77% in each group (adjusted hazard ratio in the zoledronic acid group, 0.98; 95% confidence interval [CI], 0.85 to 1.13; P = 0.79). Disease recurrence or death occurred in 377 patients in the zoledronic acid group and 375 of those in the control group. The numbers of deaths — 243 in the zoledronic acid group and 276 in the control group — were also similar, resulting in rates of overall survival of 85.4% in the zoledronic acid group and 83.1% in the control group (adjusted hazard ratio, 0.85; 95% CI, 0.72 to 1.01; P = 0.07). In the zoledronic acid group, there were 17 confirmed cases of osteonecrosis of the jaw (cumulative incidence, 1.1%; 95% CI, 0.6 to 1.7; P <0.001) and 9 suspected cases; there were no cases in the control group. Rates of other adverse effects were similar in the two study groups. Conclusions These findings do not support the routine use of zoledronic acid in the Adjuvant management of breast Cancer. (Funded by Novartis Pharmaceuticals and the National Cancer Research Network; AZURE Current Controlled Trials number, ISRCTN79831382.)

Zhimin Shao - One of the best experts on this subject based on the ideXlab platform.

  • the efficacy of zoledronic acid in breast Cancer Adjuvant Therapy a meta analysis of randomised controlled trials
    European Journal of Cancer, 2012
    Co-Authors: Tingting Yan, Wenjin Yin, Qiong Zhou, Liheng Zhou, Yiwei Jiang, Zhimin Shao
    Abstract:

    Abstract Background The effect of zoledronic acid in breast Cancer Adjuvant Therapy concerning improvement of patient survival has yet to be confirmed. We performed a meta-analysis of published and unpublished randomised controlled trials with the aim of accurate evaluation between clinical outcome and the association of the addition of zoledronic acid to Adjuvant Therapy. Methods We searched PubMed (from 1966 to present) and online abstracts from the proceeding Annual Meetings of the American Society of Clinical Oncology (ASCO) (years 1992–2010) and online abstracts from San Antonio Breast Cancer Symposium (years 2004–2010). A total of five eligible studies including 3676 subjects and 3678 controls met our search criteria and were evaluated. Random and fixed-effects meta-analytical models were used where indicated, and between-study heterogeneity was assessed. The primary study end-points were the disease free survival (DFS). Secondary end-points were overall survival (OS), distant or loco-regional recurrence free survival and bone metastasis free survival. Findings Compared with the control arm, Adjuvant breast Cancer treatment with zoledronic acid did not significantly improve overall survival, disease free survival, bone metastasis free survival, distant and locoregional recurrence free survival. However, in the postmenopausal subgroup, the addition of zoledronic acid to standard Therapy could significantly improve DFS (relative risk (RR)=0.763, 95% confidence interval (CI) 0.658–0.884, p p =0.003) and locoregional recurrence (RR=0.508, 95%CI 0.340–0.760, p =0.001). Interpretation Adjuvant zoledronic acid did not significantly improve the prognosis of breast Cancer patients. Due to the highly variable definitions of menopause utilised in different studies, we hypothesise that zoledronic acid may have a potential effect on postmenopausal patients. Additional studies are needed to evaluate the value of Adjuvant treatment of zoledronic acid in premenopausal counterparts, differing disease stages and various pathological types of breast Cancer.

Robert E. Coleman - One of the best experts on this subject based on the ideXlab platform.

  • breast Cancer Adjuvant Therapy with zoledronic acid
    The New England Journal of Medicine, 2011
    Co-Authors: Robert E. Coleman, Helen Marshall, David Cameron, David Dodwell, Roger Burkinshaw, M. Keane, Stephen Houston, Robert Grieve, Peter Barrettlee, Diana Ritchie
    Abstract:

    A b s t r ac t Background Data suggest that the Adjuvant use of bisphosphonates reduces rates of recurrence and death in patients with early-stage breast Cancer. We conducted a study to determine whether treatment with zoledronic acid, in addition to standard Adjuvant Therapy, would improve disease outcomes in such patients. Methods In this open-label phase 3 study, we randomly assigned 3360 patients to receive standard Adjuvant systemic Therapy either with or without zoledronic acid. The zoledronic acid was administered every 3 to 4 weeks for 6 doses and then every 3 to 6 months to complete 5 years of treatment. The primary end point of the study was disease-free survival. A second interim analysis revealed that a prespecified boundary for lack of benefit had been crossed. Results At a median follow-up of 59 months, there was no significant between-group difference in the primary end point, with a rate of disease-free survival of 77% in each group (adjusted hazard ratio in the zoledronic acid group, 0.98; 95% confidence interval [CI], 0.85 to 1.13; P = 0.79). Disease recurrence or death occurred in 377 patients in the zoledronic acid group and 375 of those in the control group. The numbers of deaths — 243 in the zoledronic acid group and 276 in the control group — were also similar, resulting in rates of overall survival of 85.4% in the zoledronic acid group and 83.1% in the control group (adjusted hazard ratio, 0.85; 95% CI, 0.72 to 1.01; P = 0.07). In the zoledronic acid group, there were 17 confirmed cases of osteonecrosis of the jaw (cumulative incidence, 1.1%; 95% CI, 0.6 to 1.7; P <0.001) and 9 suspected cases; there were no cases in the control group. Rates of other adverse effects were similar in the two study groups. Conclusions These findings do not support the routine use of zoledronic acid in the Adjuvant management of breast Cancer. (Funded by Novartis Pharmaceuticals and the National Cancer Research Network; AZURE Current Controlled Trials number, ISRCTN79831382.)

Carol K Redmond - One of the best experts on this subject based on the ideXlab platform.

  • breast Cancer Adjuvant Therapy time to consider its time dependent effects
    Journal of Clinical Oncology, 2011
    Co-Authors: Ismail Jatoi, William F Anderson, Jonghyeon Jeong, Carol K Redmond
    Abstract:

    Breast Cancer is a chronic and heterogeneous disease that may recur many years after initial diagnosis and treatment.1 This has important implications for the practicing oncologist. For instance, an early effect of Adjuvant treatment may diminish over time after cessation of Therapy, or, alternatively, there may exist a lag time before some treatment effects become pronounced. Indeed, the risk of breast Cancer recurrence and death (hazard rate) varies over time (ie, is nonproportional) according to prognostic and predictive factors (Figs 1 and ​and2;2; Table 1).6,13 The hazard curve for breast Cancer death peaks between 2 and 3 years after initial diagnosis and then declines sharply, suggesting that the biologic mechanisms responsible for early and late Cancer-specific events are fundamentally different. Thus the early and late effects of Adjuvant Therapy may vary accordingly.

Tingting Yan - One of the best experts on this subject based on the ideXlab platform.

  • the efficacy of zoledronic acid in breast Cancer Adjuvant Therapy a meta analysis of randomised controlled trials
    European Journal of Cancer, 2012
    Co-Authors: Tingting Yan, Wenjin Yin, Qiong Zhou, Liheng Zhou, Yiwei Jiang, Zhimin Shao
    Abstract:

    Abstract Background The effect of zoledronic acid in breast Cancer Adjuvant Therapy concerning improvement of patient survival has yet to be confirmed. We performed a meta-analysis of published and unpublished randomised controlled trials with the aim of accurate evaluation between clinical outcome and the association of the addition of zoledronic acid to Adjuvant Therapy. Methods We searched PubMed (from 1966 to present) and online abstracts from the proceeding Annual Meetings of the American Society of Clinical Oncology (ASCO) (years 1992–2010) and online abstracts from San Antonio Breast Cancer Symposium (years 2004–2010). A total of five eligible studies including 3676 subjects and 3678 controls met our search criteria and were evaluated. Random and fixed-effects meta-analytical models were used where indicated, and between-study heterogeneity was assessed. The primary study end-points were the disease free survival (DFS). Secondary end-points were overall survival (OS), distant or loco-regional recurrence free survival and bone metastasis free survival. Findings Compared with the control arm, Adjuvant breast Cancer treatment with zoledronic acid did not significantly improve overall survival, disease free survival, bone metastasis free survival, distant and locoregional recurrence free survival. However, in the postmenopausal subgroup, the addition of zoledronic acid to standard Therapy could significantly improve DFS (relative risk (RR)=0.763, 95% confidence interval (CI) 0.658–0.884, p p =0.003) and locoregional recurrence (RR=0.508, 95%CI 0.340–0.760, p =0.001). Interpretation Adjuvant zoledronic acid did not significantly improve the prognosis of breast Cancer patients. Due to the highly variable definitions of menopause utilised in different studies, we hypothesise that zoledronic acid may have a potential effect on postmenopausal patients. Additional studies are needed to evaluate the value of Adjuvant treatment of zoledronic acid in premenopausal counterparts, differing disease stages and various pathological types of breast Cancer.