Zoledronic acid: Its use in the treatment of breast cancer

Breast cancer is a very common diagnosis in women; approximately 30% of patients with breast cancer will develop bone metastases. In addition, breast cancer patients experience adjuvant treatment related bone loss. Bisphosphonates (BPs) are the standard of care for maintaining bone health in patients with cancer. The purpose of this paper is to review the evidence on the use of zoledronic acid (ZA) in breast cancer. Therapy with ZA is generally safe and well tolerated. ZA has become established in the management of patients with breast metastatic bone disease (MBD), reducing the morbidity by decreasing the rate of skeletal-related events (SREs) and the time to develop frst and subsequent SREs. Among different BPs, the strongest evidence in this setting is available for ZA. However, emerging data is currently addressing the benefit of anti-RANKL therapy versus ZA. Several trials in early breast cancer have also investigated ZA in other settings, such as for protection of bone density and in adjuvant therapy.