Department of Gynecology, Endocrinology, and Oncology, Philipps-University of Marburg, Marburg, Germany.
Academic Unit of Clinical Oncology, Weston Park Hospital, CR-UK/YCR Sheffield Cancer Research Centre, Sheffield, UK.
Ann Oncol. 2012 Nov;23(11):2782-2790. doi: 10.1093/annonc/mds169. Epub 2012 Jun 22.
Recent data from the AZURE, ABCSG-12, and ZO-FAST clinical trials have challenged our understanding of the potential anticancer activity of zoledronic acid (ZOL). Although the results of these studies may appear to be conflicting on the surface, a deeper look into commonalities among the patient populations suggest that some host factors (i.e. patient age and endocrine status) may contribute to the anticancer activity of ZOL. Indeed, data from these large clinical trials suggest that the potential anticancer activity of ZOL may be most robust in a low-estrogen environment. However, this may be only part of the story and many questions remain to be answered to fully explain the phenomenon. Does estrogen override the anticancer activity of ZOL seen in postmenopausal women? Are hormones other than estrogen involved that contribute to this effect? Does the role of bone turnover in breast cancer (BC) growth and progression differ in the presence of various estrogen levels? Here, we present a review of the multitude of factors affected by different endocrine environments in women with BC that may influence the potential anticancer activity of ZOL.
来自 AZURE、ABCSG-12 和 ZO-FAST 临床试验的最新数据挑战了我们对唑来膦酸（zoledronic acid，ZOL）潜在抗癌活性的理解。尽管这些研究的结果表面上似乎相互矛盾，但深入研究患者人群的共同点表明，一些宿主因素（即患者年龄和内分泌状态）可能有助于 ZOL 的抗癌活性。事实上，这些大型临床试验的数据表明，ZOL 的潜在抗癌活性在低雌激素环境中最为显著。然而，这可能只是部分原因，还有许多问题有待解答，才能充分解释这一现象。雌激素是否会抵消绝经后妇女中 ZOL 的抗癌活性？除了雌激素之外，还有其他激素参与其中吗？在不同的雌激素水平下，骨转换在乳腺癌（BC）生长和进展中的作用是否不同？在这里，我们回顾了受不同内分泌环境影响的多种因素，这些因素可能会影响 ZOL 的潜在抗癌活性。
