Does zoledronic acid influence quality of life in breast cancer patients?

In this article, researchers investigated the adverse effects of zoledronic acid (Zometa) in breast cancer patients. Specifically, they examined the occurrence of osteonecrosis of the jaw (ONJ) and other oral (mouth) complications.

Zoledronic acid (zoledronate) is a drug commonly used to treat osteoporosis (loss of bone mass which makes the bones more fragile, prone to fractures). Zoledronate is also being used to treat bone metastases (cancer that has spread to the bones). Previous studies have shown that the addition of zoledronate to standard chemotherapy can also improve survival for some early-stage breast cancer patients. However, because zoledronate targets bone growth, it has been linked to some bone problems, such as osteonecrosis of the jaw or ONJ (a disorder where the jaw bone becomes exposed as a result to loss of blood supply). Zoledronate might also cause problems less severe than ONJ that still affect patients' quality of life, such as oral pain. Therefore, it is important to assess how treatment with zoledronate affects oral quality of life in breast cancer patients.

To measure how frequently ONJ occurs, the researchers compared 3,360 breast cancer patients who received chemotherapy alone (the control group) or chemotherapy plus zoledronate. After five years of treatment, 468 of these patients (242 in the control group and 244 who received zoledronate) were asked to complete a questionnaire about oral quality of life. Among all 3,360 patients, ONJ was rare, but it only occurred in zoledronate-treated patients (2.1% of patients who received zoledronate). According to the questionnaire, there was no statistical difference in oral quality of life between the control group and patients who received zoledronate. Oral pain was the most common complaint, but it did not occur more frequently in control patients than in zoledronate patients. Previous dental problems (wearing dentures, tooth extractions, unhealthy gums) were strongly associated with the likelihood of developing oral problems.

In conclusion, patients who received zoledronate in addition to chemotherapy did not experience more oral problems than patients receiving chemotherapy alone.

The time between receiving treatment and developing an oral problem was shorter for the zoledronate group than in the control group, but this was not statistically significant.

This study was funded by Novartis, the manufacturer of Zometa.

Ask your doctor whether zoledronate as an addition to chemotherapy is a good treatment option for your situation.