Osteonecrosis Of The Jaw Linked To Adjuvant Zoledronic Acid
Adjuvant zoledronic acid (Zometa, Novartis) used for bone strengthening in women with breast cancer was associated with a 2.1% rate of osteonecrosis of the jaw (ONJ), in a randomized controlled trial published online June 24 in the Journal of Clinical Oncology. The study authors consider this rate of ONJ to be "encouragingly low," but an expert writing in an accompanying editorial say this rate is "not acceptable," because zoledronate did not improve disease-free survival or overall survival in the study population as a whole. In an accompanying editorial, Charles L. Shapiro, MD, from Wexner Medical Center and Comprehensive Cancer Center, Ohio State University, in Columbus, elaborates on unanswered questions regarding bisphosphonate-related ONJ (BONJ). These include specific underlying mechanism(s), why it is confined to the jaw, predisposing risk factors other than dental extractions, optimal treatments, outcomes, and health-related QOL.