唑来膦酸应用于乳腺癌辅助治疗的研究

Zoledronic acid in the adjuvant therapy for breast cancer

唑来膦酸(zoledronic acid,ZOL)是第三代双膦酸盐(bisphosphonates,BPs)药物,通过抑制破骨细胞介导的骨重吸收作用,降低骨相关事件,预防肿瘤治疗相关骨流失,提高骨密度,是目前乳腺癌骨转移的标准治疗之一。越来越多临床前研究及临床研究结果表明,ZOL这种骨改良药物,不仅仅是一种骨保护剂,还具有直接和间接的抗肿瘤活性,可降低肿瘤复发、转移,改善预后。ZOL早期应用于乳腺癌辅助治疗的应用地位得以提高,尤其是对于低雌激素水平(自然或治疗相关性)的早期乳腺癌患者。

Zoledronic acid（ZOL）,as the third generation of bisphosphonates（BPs）,has been used as the standard treatment of breast cancer with bone metastases by inhibiting the osteoclast-mediated bone destruction, reducing the incidence of skeletal complications of bone metastases, and preventing the cancer treatment-induced bone loss. However, more and more preclinical and clinical studies indicated that ZOLas a bone-modifying agent, more than just a bone protective agent, might also havedirect or indirect anticancer effect. Several international clinical trials have shown that ZOL not only prevents bone loss, but also reduces recurrence and metastasis, thus raising its application status for the adjuvant therapy of breast cancer by improving the prognosis, especially in patients with early breast cancer and lower estrogen level （naturally or as a consequence of adjuvant treatment）. The present review assesses the available evidence of the anticancer effect of ZOL in treating breast cancer.