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Table 1 Zoledronic acid trials and disease-free survival

From: Zoledronic acid effectiveness against breast cancer metastases - a role for estrogen in the microenvironment?

Trial Hormonal status ZA/hormonal intervention Effect of ZA
Z-Fast [7] (n = 602) Postmenopausal women Immediate versus delayed ZA plus adjuvant letrazole Decreased recurrence at 12 to 48 months, not at 60 months
ZO-Fast [6] (n = 868) Postmenopausal women Immediate versus delayed ZA plus adjuvant letrazole Reduction in DFS (HR = 0.59) at 36 and 48 months. Disease recurrence reduced at bone and at nonbone sites
ABCSG12 [4] (n = 1,803) Premenopausal ER/PR-positive stage 1/2 breast cancer Phase 3 2×2 trial, goserelin ± tamoxifen or anastrozole ± ZA Reduction in DFS (HR = 0.68) at 48 and 62 months. Disease recurrence reduced at bone and at nonbone sites
AZURE [5] (n = 3,360) Premenopausal and postmenopausal stage 2/3 breast cancer Phase 3 trial, standard adjuvant systemic therapy including hormonal ± ZA Lack of effect on invasive DFS. Subgroup analysis indicated benefit in women ≥5 years postmenopausal (HR = 0.75)
AZURE subgroup [72] (n = 205) Premenopausal and postmenopausal stage 2/3 breast cancer Neoadjuvant chemotherapy ± ZA Reduced residual invasive tumor size by 44%
  1. ABCSG12, Austrian Breast & Colorectal Cancer Study Group 12; AZURE, Adjuvant Zoledronic Acid to Reduce Recurrence; DFS, disease-free survival; ER, estrogen receptor; HR, hazard ratio; PR, progesterone receptor; ZA, zoledronic acid.