R Garcia-Sanz, "Zoledronic Acid As Compared With Observation In Multiple Myeloma Patients At Biochemical Relapse: Results Of The Randomized AZABACHE Spanish Trial," Haematologica, September, 2015 (full text of article)
Key takeaways:
Intravenous bisphosphonates are the standard of care for the prevention of skeletal-related events and treatment of hypercalcemia in patients with multiple myeloma. In addition, some randomized trials have shown clinical benefits for bisphosphonates in these patients when they are administered during cytotoxic therapy. These results and some preclinical studies argue in favor of an antimyeloma effect for the most potent bisphosphonates.
The present randomized trial does not support a direct antitumor effect of intravenous zoledronic acid [Zometa] when administered as single therapy in myeloma patients at biochemical relapse since no reduction in M-component or prolongation in TNT was observed. However, considering that clinical progressions in the control group were mainly due to bone disease, we may counter-argue in favor of the use of zoledronic acid in patients at biochemical relapse ...
In summary, this randomized trial demonstrates that early monotherapy with ZA reduces the risk of progression with symptomatic bone disease and minimizes the incidence of skeletal-related events without significant toxicity in multiple myeloma patients with asymptomatic biochemical relapse, and accordingly it should be considered as a new standard of care for this group of patients"
