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Zoledronic acid: clinical potential beyond the prevention of skeletal complications in patients with cancer

Adam Brufsky

Zoledronic acid has received international approval for the treatment of bone metastases and bone lesions from cancer. Phase III studies established the efficacy and safety profile of zoledronic acid in a broad range of tumor types. A direct comparison study with pamidronate demonstrated that zoledronic acid had a similar safety profile and provided superior clinical benefits in patients with breast cancer. Exploratory analyses of the large Phase III databases have demonstrated a survival benefit in patients with breast or lung cancer who achieved normalization of their biochemical marker of bone resorption, N-terminal telopeptide of Type I collagen, within 3 months of zoledronic acid therapy. Ongoing studies are evaluating zoledronic acid for the prevention of accelerated bone loss associated with aromatase inhibitors in patients with breast cancer and for the prevention of new bone metastases.