מי שמקבל קסלודה- יקבל זומרה לכל החיים?

מי שמקבל קסלודה בסרטן שד גרורתי בעצמות- יקבל זומרה לכל החיים?

האם לכאבים בעצמות-כן כדאי לקבל זומרה כל חודש, או שגם לכאבים רצוי רק פעם ב-3 חודשים?

Based on these preliminary clinical results with low-dose, intermittent zoledronic acid, Hu et al. conducted a randomized phase II clinical study in order to clarify the role of metronomic low-dose zoledronic acid. Sixty breast cancer patients with bone metastases were randomized to receive either 1 mg intravenous zoledronic acid weekly for 4 doses, or a single 4 mg intravenous dose of zoledronic acid. Administration of other treatments was delayed for 1 month. Serial blood samples were collected on days 1, 15, 29, and at 3 months. Serum VEGF alteration was the primary endpoint. Compared to the conventional arm, the metronomic arm exhibited a significantly greater reduction in serum levels of VEGF and N-telopeptide of type I collagen (NTx) during the first month of treatment. Serum CA 15-3 level stabilized over time in the metronomic arm, but increased in the conventional arm. Independent prognostic factors for PFS included chemotherapy received (HR 8.042, p=0.000), ER status (HR 2.837, p=0.020), VEGF levels at 3 months after intervention (HR 2.026, p=0.045), and baseline NTx (HR 1.051, p=0.001). This is the first study to demonstrate that metronomic weekly low-dose zoledronic acid could be more effective than the conventional zoledronic acid dosing schedule https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4648996/ ואני אפילו בעד 1.5 מ"ג (במקום 1 מ"ג) פעם בשבוע.