A case-control study was conducted in Australia to assess and investigate the association between use and potential chemopreventive effects of nitrogen-based bisphosphonates for Epithelial ovarian cancer and aimed to comprehensively assess the association between nitrogen-based bisphosphonate use and risk of Epithelial ovarian cancer. The study included all women with epithelial ovarian cancer diagnosed at age 50 years and older between 1st July 2004 and 31st December 2013

Karen Tuesley of the University of Queensland School of Public Health, in Brisbane, and colleagues used large linked administrative dataset to study the association between use of nitrogen-based bisphosphonates and risk of epithelial ovarian cancer, overall and by histotype.
The study showed that, "among women aged over 50 years, use of nitrogen-based bisphosphonates was associated with reduced EOC risk, with an almost 50% lower risk of the endometrioid histotype, and a 16% lower risk of serous cancers. Risk reduction appeared stronger for use longer than a year compared to less but did not clearly reduce further beyond this. There was no apparent association between use of nitrogen-based bisphosphonates and clear cell or mucinous histotypes".The findings were consistent with a previous meta-analysis of observational studies
The study was published in Journal of the National Cancer Institute, on March 9, 2022
They note that nitrogen-based bisphosphonates have been shown to inhibit the mevalonate pathways within macrophages and monocytes, thereby reducing activity of tumor-associated macrophages and activating gamma delta T cells.
Inhibition the mevalonate pathways within macrophages and monocytes, resulted in reducing activity of tumor-associated macrophages and activating gamma delta T cells and potentially inhibit ovarian tumor cells proliferation.
The researchers concluded that nitrogen-based bisphosphonates was associated with a reduced risk of endometrioid and serous ovarian cancer. and there is benefit of using an existing chronic disease medication, potentially just a yearly injection.