The Future of Zometa in Breast Cancer Treatment


July 7, 2008 — A recent study suggests the osteoporosis drug Zometa reduces breast cancer recurrence in premenopausal women. In this edition of Siteman Cancer Center’s podcast series, medical oncologist Michael Naughton, MD, discusses the study and the effect it may have on treatment.

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On this edition of Cancer Connection, we’ll talk about the drug Zometa and its potential future in the fight against breast cancer.

Host: Thanks for downloading this podcast from the Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine in St Louis. I’m Jason Merrill.

At a recent meeting of the American Society of Clinical Oncology, or ASCO, researchers announced they found a drug used to treat osteoporosis lowered the risk of breast cancer recurrence in premenopausal women with early breast cancer. The Siteman Cancer Center in St. Louis was part of a study examining the effect of Zometa on bone loss in women undergoing chemo for breast cancer. Joining us is one of the study authors, Mike Naughton. He is an oncologist specializing in breast cancer at the Siteman Cancer Center. Dr. Naughton, thank you for joining us.

Naughton: My pleasure.

Host: What is Zometa?

Naughton: Zometa is a medication that’s a member of a family of medications called bisphosphonates. Bisphosphonates are medicines that inhibit a particular cell in the bone that allows calcium to be leached out of the bone, called the osteoclast. So Zometa is an osteoclast inhibitor.

Host: At a recent ASCO meeting, the drug made some headlines. What was found?

Naughton: Well an exciting study was presented at ASCO. This was a study in young women with breast cancer. The women on the study were all premenopausal, and all the women received what’s called ovarian suppression, which means they were put into menopause. And then half the women were treated with Zometa, and half were not. One of the important findings was to find out how good Zometa was for their bones in terms of keeping them strong and preventing osteoporosis. And it actually worked quite well for that, but even more exciting, of the women who had the Zometa, a smaller percentage of those women had the cancer come back than those who did not receive Zometa.

Host: So why do you think an osteoporosis drug could help breast cancer patients?

Naughton: Well this is an area that we’ve been interested in for a long time. There’s a theory called the seed-in-soil theory, which means cancer cells spread throughout the body, but for them to survive, they have to find a hospitable environment. And it turns out the bone marrow is a very hospitable environment for breast cancer cells. These osteoporosis drugs inhibit the osteoclasts in the bone, and we think this might inhibit the bone from being such a welcoming environment for the breast cancer cells.

Host: So why is this promising news for breast cancer patients?

Naughton: As you know, we’re always looking for better strategies to help women with breast cancer not recur with their disease and improve our chances of curing them. And if the study presented at ASCO is accurate, then this really looks like it could be another way to help women not have their breast cancer come back.

Host: Obviously this was only one study, but when do you think treating breast cancer patients with Zometa may become a part of standard therapy?

Naughton: We are using Zometa in select situations now primarily because of its bone-protective effects. But for the general woman with breast cancer, where it would be part of everyday therapy, maybe within the next year or so because several other studies are likely to be presented over the next year or so, and if they support the findings, we may all start using Zometa on a more regular basis.

Host: So you think this could become part of standard treatment for every breast cancer patient?

Naughton: I think that the data is growing to support Zometa in this setting, so I wouldn’t be surprised if over the next year, if we see positive results in these other studies, that we actually adopt this as one of our routine treatments.

Host: When we talked about this before this interview, you were saying this could be practice-changing. Do you really still believe that?

Naughton: I think there’s a very good chance. There’s a growing body of evidence. The one study at ASCO certainly supports the idea. We do need some confirmation, and we have at least two additional studies that will hopefully get presented by the end of this year that may support that. And if that happens, I think we’re likely to start incorporating Zometa on a more regular basis. We actually did present a study from Siteman at the meeting as well that supports this finding. We had a study where we treated women with Zometa – 60 women with Zometa, 60 without – and actually took bone marrow samples and looked for cancer cells. And it turned out that women who had the Zometa had fewer cancer cells in their bone marrow after three months of therapy.

Host: Dr. Naughton, thank you for joining us.

Naughton: My pleasure.

Host: For more information about breast cancer, you can visit the Siteman Cancer Center online at or call 800-600-3606. Thanks for downloading. Until next time, I’m Jason Merrill.