Zoledronic acid: multiplicity of use across the cancer continuum.

Zoledronic acid (ZOL) has proven efficacy for reducing the risk of skeletal-related events in patients with bone metastases from a broad range of solid tumors and bone lesions from multiple myeloma. In a head-to-head trial in patients with breast cancer, ZOL demonstrated efficacy at least comparable with, and some benefits beyond those of, pamidronate. Several studies have also demonstrated additional benefits from ZOL, including preventing bone loss, and potential anticancer activity. Adding ZOL to anticancer therapy improved disease-free and overall survival in clinical trials in women receiving adjuvant endocrine therapy for breast cancer and in patients with newly diagnosed multiple myeloma. Thus, recent advances suggest that, in addition to its established role in reducing skeletal morbidity, ZOL might also help preserve bone health in patients with early stage breast cancer. The potential role of ZOL as an anticancer therapy in this setting is the focus of intense investigation and awaits insights from ongoing clinical trials.