Known as a bisphosphonate, zoledronic acid is typically used for bone diseases such as osteoporosis, and to treat high calcium levels in the blood that can lead to other health complications. Nitrogen containing bisphosphonates like zoledronic acid are known to have cancer suppressing qualities, and scientists and researchers were eager to find out if zoledronic acid would have a positive effect on the survival rate for mesothelioma patients.
Preclinical studies have found that when zoledronic acid was given to animal test subjects, mesothelioma cells did not continue to grow and the treatment affected the cells in a multitude of ways. Zoledronic acid blocked angiogenesis, which prevents new blood vessels from forming and stops blood from reaching the tumor. Results also showed melvalonate pathways were inhibited, an action that researchers believe is a characteristic of anti-cancer properties, because that particular pathway is imperative for cell growth. Apoptosis, or programmed cell death, also occurred along with the alteration of metalloproteinases, which affects how invasive the cancer cells are. This prompted scientists and researchers to investigate zoledronic acid in a pilot single-arm trial of malignant pleural mesothelioma patients.
Participants in this Phase II clinical trial consisted of 8 men whose disease progression did not decrease after chemotherapy treatments, and their conditions were too poor to continue receiving standard treatment. According to the Clinical Trials, zoledronic acid was administered by infusion daily for a three- week cycle, followed by a tumor assessment via CT or PET scan every two cycles.
After reviewing the PET and CT scans, scientists found that those who were already stable continued to improve, partially responding to the treatment. A patient, who had the disease that was previously progressing, showed signs of stabilization. Those who failed to respond to zoledronic acid had high levels of VEGF and osteopontin from prior treatments.
Overall results showed mesothelioma patients lived on average of 7 months after treatment, ranging anywhere from 24 days to 28 months.
Mesothelioma is a rare and aggressive cancer that is difficult to treat because in most cases the cancer is in the advanced stages before it is detected. While early diagnosis is key, scientists and researchers are continually looking to new methods to help those who are already in the advanced stages and in a situation where traditional methods of treatment are not having the desired effect.
Jamil, MO et.al., “A Pilot Study of Zoledronic Acid in the Treatment of Patients with Advanced Malignant Pleural Mesothelioma,” Lung Cancer (2017 June). [Link]
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