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医学--唑来膦酸的抗肿瘤特性
* * * * * * * * AZURE研究根绝月经状态分层分析 低雌激素水平患者使用ZOL带来DFS获益 Typical Odds Ratio 月经状态分层分析 绝经前、绝经 5年 及月经状态不明 绝经5 年 ?21 (heterogeneity) = 5.34; P = .02 Odds Reduction (± SD) 1.2 1.4 1.6 1.8 2.0 0.2 0.4 0.6 0.8 N = 1,041 247 events N = 2,318 505 events 高雌激素水平 低雌激素水平 HR = 0.76 (95% CI = 0.60, 0.98) HR = 1.13 (95% CI = 0.95, 1.35) CI = confidence interval; DFS = disease-free survival; HR = hazard ratio; SD = standard deviation. *Adjusted for imbalances in estrogen receptor status, lymph node status, and T stage. Coleman RE, et al. SABCS 2010. Abstract S4-5. Figures reprinted courtesy of Prof. RE Coleman. ZOM130717136 AZURE 绝经前亚组分析: ZOL vs No ZOL 无DFS及OS差异 CI = confidence interval; CTL = control; DFS = disease-free survival; HR = hazard ratio; OS = overall survival; ZOL = zoledronic acid. Left image reprinted from Coleman RE, et al. NEJM. 2011 Sept 25 Epub; right image adapted from Coleman RE, et al. SABCS 2010, abstract S4-5. DFS事件 DFS Events, n 228 (20.2%) 261 (23.1%) Total events n = 1,127 n = 1,131 Adjusted HR = 0.97 (95% CI = 0.78, 1.21) P = .81 161 vs 165 events 绝经前、围绝经期、及月经状态不明 1.0 Proportion Surviving 0.8 0.6 0.4 0.2 0.0 No. at Risk ZO L 0 Time Since Randomization, months 6 12 18 24 30 36 42 48 54 60 66 72 78 84 1 ,162 1 ,131 1,078 1,020 955 466 71 0 Control 1 ,156 1 ,123 1,076 1,032 963 446 60 0 Control ZOL ZOM130717136 0 Overall Survival ? 26% AZURE 绝经后亚组分析: ZOL有效改善OS及减少DFS事件 1 2 3 4 5 6 7 20 40 60 80 Time, years Zoledronic acid (n= 519) Control (n = 522) Adjusted HR = 0.74 P = .04 0 100 Patients Surviving, % n = 551 n = 550 DFS Events* DFS Events, n *This analysis included women 60 y old with unknown menopausal status in the postmenopausal 5 y group. DFS = disease-free survival; OS = overall survival; ZOL = zoledronic acid. Left image reprinted from Coleman RE, et al. NEJM. 2011 Sept 25 Epub; right image adapted from Coleman RE, et al. SABCS 2010, abstract S4-5. ZOM130717136 AZURE 结论 辅助 ZOL并不能为所有
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