Brittle-bones drug offers hope to older breast cancer patients

Results of a worldwide trial led by experts from Sheffield and Leeds universities, announced at the European Multidisciplinary Cancer Congress in Stockholm, show the drug zoledronic acid, used mainly to treat osteoporosis, improves the survival of post-menopausal patients.

Some 85 per cent of older women receiving the drug to aid chemotherapy treatment survived five years, compared to 79 per cent who did not get the drug.

But the £6m Azure trial, which has been under way since 2003, found no significant difference in overall survival in more than 3,300 women divided between those who did and did not receive the drug and some evidence it could have an adverse impact on younger women.

Doctors say the results shed new light on the role that bones could play in the progress of the disease, suggesting bone marrow could be an important sanctuary for tumour cells which could be reactivated sometimes many years later, allowing the illness to recur.

Prof Robert Coleman, of Sheffield University, who led the trial, said: “The results have shown that zoledronic acid should not be used routinely for the treatment of early breast cancer. However, for those with low levels of female hormones, due either to natural ageing or specific treatments to induce menopause, the approach appears very promising as more women go on to rid themselves of the disease.

“Our findings could mean a major new treatment approach for the tens of thousands of women in the UK who develop breast cancer.”

A separate study published at the conference yesterday has revealed giving women with early-stage breast cancer radiotherapy between or during cycles of chemotherapy also reduces the risk of the disease recurring.

Experts said findings from the trial involving nearly 2,300 women at 48 hospitals across the UK should change the way patients are treated.

The treatment has minimal adverse side-effects and no detrimental effect on the patients’ quality of life. Cancer specialist Indrajit Fernando, from Birmingham, said it reduced the risk of local cancer recurrence by 35 per cent and could also shorten treatment times.

Currently patients are usually given chemotherapy followed by radiotherapy after surgery to destroy any remaining cancer cells in the breast, chest wall or underarm area, in order to reduce risk of recurrence but the timing of the treatment has been a major debate among doctors. Evidence suggests one death from breast cancer can be avoided for every four cases of local reccurrence which can be prevented.

“Shortening the overall treatment time may mean that when patients have finished their last chemotherapy course they can return to their normal life without having to then complete their radiotherapy. This may also have economic benefits in terms of when patients can return to work,” he said.

A third study to be unveiled today finds the make-up of tumours changes throughout the course of breast cancer and regular checks are needed to ensure the best treatment in patients who relapse.

Researchers discovered the hormonal status of tumours could change throughout the course of the illness but decisions about the most effective treatment were based on one examination of the initial tumour. Hormones oestrogen and progesterone can be key drivers of tumour growth.

Linda Lindström, who led the work in Stockholm, said: “Until now we thought that these predictive markers remained stable during the course of the cancer. But it is now apparent that these breast tumours markers, which are used to decide the best treatment for the patient, change as the tumour progresses and this significantly affects the way patients respond to particular therapies.”