Zoledronic acid is superior to pamidronate in patients with breast cancer and bone metastases

Bisphosphonate Therapy for Patients with Breast Cancer

“…The proportion of patients who experienced at least 1 SRE in the 4-mg zoledronic acid and 90-mg pamidronate treatment groups was similar after 24 months of treatment (46% for zoledronic acid versus 49% for pamidronate, respectively); however, zoledronic acid consistently reduced the percentage of patients with each type of SRE compared with pamidronate ( Fig. 3) [28]. Notably, significantly fewer patients treated with zoledronic acid required radiation therapy to bone (19% for zoledronic acid versus 27% for pamidronate; P = .011) [29].…”

Role of Bisphosphonates for the Management of Skeletal Complications and Bone Pain from Skeletal Metastases

“…Moreover, over 25 months, significantly fewer patients treated with zoledronic acid required RT to bone compared with the pamidronate group (19% vs. 27% for pamidronate; P = 0.011). 37 In a placebo-controlled trial of Japanese women with bone metastases from breast cancer, 4-mg zoledronic acid every 4 weeks significantly reduced composite BPI scores throughout the 12-month study (P = 0.0004 at 12 months compared with baseline; Figure 3). 23 In contrast, patients in the placebo group had a steady increase from mean baseline pain scores over the entire duration of the study.…”

“…3,35 However, zoledronic acid reduced the percentage of patients with each type of SRE and significantly reduced the overall risk of experiencing an SRE by an additional 16% compared with pamidronate based on the Andersen-Gill multiple event analysis (P = 0.03). 35,37 Moreover, in the subset of 766 patients with breast cancer, zoledronic acid was superior to pamidronate and significantly reduced the risk of developing an SRE by an additional 20% compared with pamidronate (P = 0.025). 35 Zoledronic acid has also demonstrated superiority to pamidronate for the treatment of hypercalcemia of malignancy in patients with multiple myeloma, breast cancer, and a variety of other solid tumors.…”

Bone Metastases in Breast Cancer

“…Both IV and oral bisphosphonates have been shown to provide significant clinical benefits in patients with bone metastases from breast cancer in randomized trials (see Table 1). 3,[9][10][11][12][13][14][15][16] Conservative assessments of treatment effects include first-event analyses, such as percentage of patients with at least one skeletal complication or time to first skeletal complication, and are preferred end-points for regulatory approval by the US Food and Drug Administration (FDA). 17 Treatment effect on incidence of pathologic fractures is particularly important.…”