Zoledronic Acid in First-Line Treatment of Prostate Cancer

Abstract

In this issue's Oncology Scan ( 1 Buyyounouski M.K.K. Oncology scan—new treatment and no treatment: Enduring issues in the management of prostate cancer. Int J Radiat Oncol Biol Phys. 2015; 91: 1-2 Abstract Full Text Full Text PDF Google Scholar , 2 Song D. Oncology Scan—rising stars, fading stars, and shooting stars: New trends in prostate cancer management. Int J Radiat Oncol Biol Phys. 2014; 89: 4-6 Abstract Full Text Full Text PDF PubMed Scopus (2) Google Scholar ), we review new possibilities for systemic therapy combined with radiation in locally advanced prostate cancer. Androgen suppression (AS) has been an established first-line systemic treatment of advanced prostate cancer for many decades. The addition of radiation therapy is known to improve overall survival in comparison with AS alone in locally advanced prostate cancer without the evidence of metastases ( 3 Mottet N. Peneau M. Mazeron J.J. et al. Addition of radiotherapy to long-term androgen deprivation in locally advanced prostate cancer: An open randomised phase 3 trial. Eur Urol. 2012; 62: 213-219 Abstract Full Text Full Text PDF PubMed Scopus (110) Google Scholar , 4 Warde P. Mason M. Ding K. et al. Combined androgen deprivation therapy and radiation therapy for locally advanced prostate cancer: A randomised, phase 3 trial. Lancet. 2011; 378: 2104-2111 Abstract Full Text Full Text PDF PubMed Scopus (459) Google Scholar , 5 Widmark A. Klepp O. Solberg A. et al. Endocrine treatment, with or without radiotherapy, in locally advanced prostate cancer (SPCG-7/SFUO-3): An open randomised phase III trial. Lancet. 2009; 373: 301-308 Abstract Full Text Full Text PDF PubMed Scopus (688) Google Scholar ). Several new systemic treatments, such as docetaxel, cabazitaxel, enzalutamide, arbiraterone, radium-223, and sipuleucel-T, have been introduced in recent years in castrate-refractory prostate cancer, on the basis of studies showing a survival benefit ( 6 James N.D. Sydes M.R. Clarke N.W. et al. Addition of docetaxel, zoledronic acid, or both to first-line long-term hormone therapy in prostate cancer (STAMPEDE): Survival results from an adaptive, multiarm, multistage, platform randomised controlled trial. Lancet. 2016; 387: 1163-1177 Abstract Full Text Full Text PDF PubMed Scopus (1347) Google Scholar ). Zoledronic acid (ZA) and denosumab are bone-targeted agents, reducing the risk of skeletal-related events ( 7 Saad F. Gleason D.M. Murray R. et al. Long-term efficacy of zoledronic acid for the prevention of skeletal complications in patients with metastatic hormone-refractory prostate cancer. J Natl Cancer Inst. 2004; 96: 879-882 Crossref PubMed Scopus (1003) Google Scholar , 8 Smith M.R. Egerdie B. Hernandez T.N. et al. Denosumab in men receiving androgen-deprivation therapy for prostate cancer. N Engl J Med. 2009; 361: 745-755 Crossref PubMed Scopus (929) Google Scholar ).