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D-1 Bisphosphonate Bone Metastases Trials Proportion of Patients With Any SRE § (12, 010) Patients, % TreatmentN 3 mo6 mo9 mo12 mo Pamidronate Study 12.

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Presentation on theme: "D-1 Bisphosphonate Bone Metastases Trials Proportion of Patients With Any SRE § (12, 010) Patients, % TreatmentN 3 mo6 mo9 mo12 mo Pamidronate Study 12."— Presentation transcript:

1 D-1 Bisphosphonate Bone Metastases Trials Proportion of Patients With Any SRE § (12, 010) Patients, % TreatmentN 3 mo6 mo9 mo12 mo Pamidronate Study 12 Pam 90 mg19810212428 Placebo17921324144 ZOMETA ® Study 010 ZOMETA 4 mg18331384047 ZOMETA 8/4 mg16031394549 Pam 90 mg16725404549 42 §Intent-to treat.

2 D-2 Bisphosphonate Bone Metastases Trials Demographic and Prognostic Variables (12, 010) Pamidronate Study 12 ZOMETA ® Study 010 PamZOMETAZOMETA Pam 90 mgPlacebo4 mg8/4 mg 90 mg Variable N = 198N = 179N = 183N = 160N = 167 Age, yr Mean ± s.d.64.1 ± 9.462.7 ± 10.163.1 ± 10.5262.2 ± 11.3762.6 ± 11.41 Median66.063.062.063.062.0 Time from initial diagnosis to Visit 2, mo Mean ± s.d.30.5 ± 32.227.7 ± 33.518.0 ± 32.2413.5 ± 21.7517.3 ± 28.62 Median19.314.42.82.62.7 42

3 D-3 Bisphosphonate Bone Metastases Trials Proportion of Patients With Pathologic Fractures § (12, 010) Pamidronate Study 12: Proportion of patients with pathologic fracture in the 3 mo prior to study entry Time from diagnosisWithout pathologicWith pathologic to study entryNfractures, %fractures, %  6 mo1157525 > 6 mo2779010 ZOMETA ® Study 010: Proportion of pamidronate patients with pathologic fracture Time from diagnosis Patients, % to study entryN3 mo6 mo9 mo13 mo  6 mo10421384045 > 6 mo 6215243237 42 §Intent-to treat.

4 D-4 Patients With Any SRE up to End-of-Core by Race (010, 011, 039) Patients, n/N (%) StudyZOMETA ® ZOMETAPam 90 mg/ numberRace4 mg8/4 mgplacebo 010N = 561N = 524N = 555 White225/493 (46)206/443 (47)234/484 (48) Black10/34 (29)22/42 (52)13/43 (30) Other13/34 (38)14/39 (36)10/28 (36) 011N = 257N = 266N = 250 White91/229 (40)85/238 (36)103/226 (46) Black4/15 (27)4/15 (27)4/12 (33) Other2/13 (15)3/13 (23)4/12 (33) 039N = 214N = 221N = 208 White64/178 (36)69/186 (37)77/172 (45) Black4/24 (17)7/19 (37)8/19 (42) Other3/12 (25)9/16 (56)7/17 (41) 54

5 D-5 ZOMETA ® Efficacy in Bone Metastases Prostate cancer (039) Solid tumors –PC/BC (011) Breast cancer and multiple myeloma (010) N =214221208257266250564526558 29 HCM (036, 037) 444236

6 D-6 Solid Tumors – PC/BC Antineoplastic Therapies After Start of Study Drug (011) Patients, n (%) ZOMETA ® ZOMETA 4 mg8/4 mgPlacebo Antineoplastic therapy N = 254N = 265N = 247 37 Any192(75.6)184(69.4)181(73.3) Carboplatin74(29.1)58(21.9)65(26.3) Paclitaxel52(20.5)58(21.9)46(18.6) Gemcitabine hydrochloride39(15.4)28(10.6)25(10.1) Cisplatin37(14.6)46(17.4)41(16.6) PTT 8.2-4

7 D-7 Breast Cancer and Multiple Myeloma Frequency Distribution of Antineoplastic Regimens (010) (1) Patients, n (%) ZOMETA ® ZOMETAPam No. of 4 mg8/4 mg90 mg StratumregimenN = 563N = 524N = 556 37 Multiple myeloma, n 186 160 167 011(5.9)10(6.3)11(6.6) 174(39.8)58(36.3)72(43.1) 243(23.1)43(26.9)41(24.6) 329(15.6)31(19.4)21(12.6) 417(9.1)11(6.9)12(7.2)  512(6.5)7(4.4)10(6.0) PTT 8.2-7

8 D-8 Breast Cancer and Multiple Myeloma Frequency Distribution of Antineoplastic Regimens (010) (2) Patients, n (%) ZOMETA ® ZOMETAPam No. of 4 mg8/4 mg90 mg StratumregimenN = 563N = 524N = 556 37 Breast cancer with chemotherapy, n 176 169 179 03(1.7)5(3.0)6(3.4) 153(30.1)51(30.2)58(32.4) 261(34.7)65(38.5)56(31.3) 334(19.3)22(13.0)35(19.6) 411(6.3)17(10.1)16(8.9)  514(8.0)9(5.3)8(4.5) Breast cancer with hormonal therapy, n 201 195 210 03(1.5)1(0.5)3(1.4) 193(46.3)114(58.5)91(43.3) 259(29.4)48(24.6)69(32.9) 332(15.9)19(9.7)34(16.2) 47(3.5)7(3.6)8(3.8)  57(3.5)6(3.1)5(2.4) PTT 8.2-7

9 D-9 Solid Tumors – PC/BC Frequency Distribution of Antineoplastic Regimens (011) Patients, n (%) ZOMETA ® ZOMETA No. of 4 mg8/4 mgPlacebo StratumregimenN = 254N = 265N = 247 37 Non small cell lung cancer, n 120 130 117 020(16.7)29(22.3)25(21.4) 150(41.7)65(50.0)67(57.3) 236(30.0)24(18.5)16(13.7) 39(7.5)6(4.6)5(4.3) 45(4.2)3(2.3)3(2.6)  50(0)3(2.3)1(0.9) Other solid tumors, n 134 135 130 042(31.3)52(38.5)41(31.5) 161(45.5)60(44.4)54(41.5) 222(16.4)17(12.6)29(22.3) 38(6.0)3(2.2)4(3.1) 41(0.7)3(2.2)1(0.8)  50(0)0(0)1(0.8) PTT 8.2-7

10 D-10 Solid Tumors –PC/BC Time to First SRE Deaths and Dropouts Considered SREs (011) Median time, P -value N (%) § daysvs placebo ZOMETA ® 4 mg257 (73)127.006 ZOMETA 8/4 mg266 (80)105.184 Placebo250 (82)85 §Kaplan-Meier estimate of the proportion at Month 9.

11 D-11 Breast Cancer and Multiple Myeloma Time to First SRE Deaths and Dropouts Considered SREs (010) Median time, P -value N (%) § daysvs Pam 90 mg ZOMETA ® 4 mg561 (58)312.099 ZOMETA 8/4 mg555 (59)265.545 Pam 90 mg524 (61)252 §Kaplan-Meier estimate of the proportion at Month 13.

12 D-12 Prostate Cancer Time to First SRE Deaths and Dropouts Considered SREs (039) Median time, P -value N (%) § daysvs placebo ZOMETA ® 4 mg214 (66)337.030 ZOMETA 8/4 mg221 (74)195.924 Placebo208 (73)221 §Kaplan-Meier estimate of the proportion at Month 15.

13 D-13 Cumulative Incidence Rate of SRE All Patients § (039) ZOMETA 4 mg21418014911397857045 ZOMETA 8/4 mg22117713210277614634 Placebo20817112810378644331 Median time, days ZOMETA® 4 mg NRP =.013 ZOMETA 8/4 mgNRP =.357 Placebo337 039 PTF 9.2-52p3 21 §Intent-to-treat. NR = Not reached.

14 D-14 Prostate Cancer Median Serum PSA Level (Observed) (039) ZOMETA 4 mg21215016213285102906067 ZOMETA 8/4 mg21815815614669106744553 Placebo20014515213972102774951 ZOMETA® 4 mg ZOMETA 8/4 mg Placebo 039 PTF 9.2-56 54

15 D-15 Prostate Cancer Total Number of SREs (039) With 21-day window Without 21-day window ZOMETA ® ZOMETA 4 mg Placebo4 mgPlacebo SRE (+HCM)112155167258 SRE112155167256 Pathologic fracture 34 544684 Vertebral fracture 10 201030 Nonvertebral fracture 25 383654 Radiation to bone 65 8590130 Surgery to bone 5 858 Spinal cord compression 10 151317 Change to antineoplastic therapy 13 171317 Hypercalcemia 0 202 56 Pro 011 PTT 9.2-6xx

16 D-16 Cumulative Incidence Rate of SRE All Patients § (011) ZOMETA 4 mg2571731076246 ZOMETA 8/4 mg266177995640 Placebo250152814836 Median time, days ZOMETA® 4 mg314P =.044 ZOMETA 8/4 mgNRP =.037 Placebo185 011 PTF 9.2-52p3 20 §Intent-to-treat. NR = not reached.

17 D-17 Solid Tumors –PC/BC Total Number of SREs (011) With 21-day window Without 21-day window ZOMETA ® ZOMETA 4 mg Placebo4 mgPlacebo SRE (+HCM)131163201275 SRE131156201267 Pathologic fracture 48 63 69 95 Vertebral fracture 21 32 27 41 Nonvertebral fracture 31 34 42 54 Radiation to bone 79 101112153 Surgery to bone 12 9 12 9 Spinal cord compression 7 10 8 10 Hypercalcemia 0 8 0 8 56 Pro 011 PTT 9.2-6xx

18 D-18 Breast Cancer and Multiple Myeloma Total Number of SREs (010) With 21-day window Without 21-day window ZOMETA ® PamZOMETAPam 4 mg 90 mg4 mg 90 mg SRE (+HCM)411451808849 SRE408440801835 Pathologic fracture301292622584 Vertebral fracture131133202214 Nonvertebral fracture206198420370 Radiation to bone105143141196 Surgery to bone 23 36 25 37 Spinal cord compression 12 16 13 18 Hypercalcemia 7 14 7 14 56 Pro 011 PTT 9.2-6xx

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