title: Prolonged Use of Zoledronic Acid (4 Years) Did Not Improve Outcome in Multiple Myeloma Patients.
abstract: Bisphosphonates, especially zoledronic acid (ZA), show antitumor effects in multiple myeloma (MM) and other neoplasms. The standard time for ZA administration has been 2 years. However, with improvement in overall survival (OS) in MM with new agents, it unclear whether ZA could be administered for a prolonged time to improve OS.
  
  
  
  A total of 170 patients with untreated, symptomatic MM were randomly divided into a group to receive ZA for 4 years, with a control group to receive ZA for 2 years. All patients were treated with the same induction therapy and stem-cell transplantation.
  
  
  
  Actuarial curves at 5 years, showed that progression-free survival was 75% (95% confidence interval [CI], 64%-82%) and OS was 68% (95% CI, 60%-76%) in the 4-year group, which was not statistically significantly different compared with the control group: 72% (95% CI, 62%-78%) and 68% (95% CI, 60%-75%; P = .67). However, the 4-year group showed reduced skeletal events (21% occurrence rate); this was statistically significant compared with the control group: 43% (P < .001).
  
  
  
  Although ZA did not improve OS in patients with MM; it continued to be useful to reduce skeletal events, and thus improve better quality of life for patients.
authors.affiliation: Oncology Research Unit, Oncology Hospítal, National Medical Center, IMSS, México, Federal District, Mexico. Electronic address: aamiranda12@gmail.com.
authors.forename: Agustin
authors.initials: A
authors.lastname: Avilès
authors.affiliation: Department of Hematology, Oncology Hospítal, National Medical Center, IMSS, México, Federal District, Mexico.
authors.forename: Maria-Jesùs
authors.initials: MJ
authors.lastname: Nambo
authors.affiliation: Department of Hematology, Oncology Hospítal, National Medical Center, IMSS, México, Federal District, Mexico.
authors.forename: Judith
authors.initials: J
authors.lastname: Huerta-Guzmàn
authors.affiliation: Department of Hematology, Oncology Hospítal, National Medical Center, IMSS, México, Federal District, Mexico.
authors.forename: Sergio
authors.initials: S
authors.lastname: Cleto
authors.affiliation: Department of Hematology, Oncology Hospítal, National Medical Center, IMSS, México, Federal District, Mexico.
authors.forename: Natividad
authors.initials: N
authors.lastname: Neri
mesh_terms: D000328:Adult; D000368:Aged; D050071:Bone Density Conservation Agents / Q000008:administration & dosage*; D004164:Diphosphonates / Q000008:administration & dosage*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007093:Imidazoles / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy*; D011788:Quality of Life; D000077211:Zoledronic Acid
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D007093:Imidazoles; D000077211:Zoledronic Acid
keywords: Bisphosphonates; Maintenance therapy; Multiple myeloma; Skeletal events; Zoledronic acid