Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • News & Views
  • Published:

Medical oncology

Zoledronic acid for breast cancer therapy-induced bone loss

The addition of zoledronic acid to aromatase inhibitors is associated with improved bone mineral density, but not with an effect on clinically-meaningful end points such as fractures. The oncology community should prioritize the design of trials evaluating more relevant end points, such as fragility fracture risk, for treatment-induced bone loss and critically assess the effects of such treatment on breast cancer survival.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Figure 1

References

  1. Howell, A. et al. Results of the ATAC (Arimidex, Tamoxifen, Alone or in Combination) trial after completion of 5 years' adjuvant treatment for breast cancer. Lancet 365, 60–62 (2005).

    Article  CAS  Google Scholar 

  2. Brufsky, A. M. et al. Zoledronic acid effectively prevents aromatase inhibitor-associated bone loss in postmenopausal women with early breast cancer receiving adjuvant letrozole: Z.-FAST study 36-month follow-up results. Clin. Breast Cancer 9, 77–85 (2009).

    Article  CAS  Google Scholar 

  3. Eidtmann, H. et al. The effect of zoledronic acid on aromatase inhibitor associated bone loss in postmenopausal women with early breast cancer receiving adjuvant letrozole: 36 months follow-up of ZO-FAST. Cancer Res. 69, 74S (American Association for Cancer Research, 2009).

    Article  Google Scholar 

  4. Lombarto, A. et al. Effect of zoledronic acid on aromatase inhibitor-associated bone loss in postmenopausal women with early breast cancer receiving adjuvant letrozole: E-ZO-FAST 36-month follow up. Proc. American Soc. Clinical Oncology 213 (American Society of Clinical Oncology, 2009).

  5. Seeman, E. Is a change in bone mineral density a sensitive and specific surrogate of anti-fracture efficacy? Bone 4 1, 308–317 (2007).

    Article  Google Scholar 

  6. Forbes, J. F. et al. Effect of anastrozole and tamoxifen as adjuvant treatment for early-stage breast cancer: 100-month analysis of the ATAC trial. Lancet Oncol. 9, 45–53 (2008).

    Article  Google Scholar 

  7. Gnant, M. et al. Endocrine therapy plus zoledronic acid in premenopausal breast cancer. N. Engl. J. Med. 360, 679–691 (2009).

    Article  CAS  Google Scholar 

  8. Coleman, R. et al. Impact of zoledronic acid in postmenopausal women with early breast cancer receiving adjuvant letrozole: Z-FAST, ZO-FAST, and E-ZO-FAST. Cancer Res. 69, 733S (American Association for Cancer Research, 2009).

    Google Scholar 

  9. Ellis, G. K. et al. Randomized trial of denosumab in patients receiving adjuvant aromatase inhibitors for nonmetastatic breast cancer. J. Clin. Oncol. 26, 4875–4882 (2008).

    Article  CAS  Google Scholar 

  10. Woodward, E. J. et al. Five year efficacy in cancer survivors of a single dose of zoledronic acid 4 mg in osteopenia and annual dosing in osteoporosis. The IX International Meeting on Cancer Induced Bone Disease (Cancer and Bone Society, 2009).

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Eitan Amir.

Ethics declarations

Competing interests

Robert Josse declares he is on the speaker's bureau for, and gets grant/research support from, Amgen and Novartis. Mark Clemons declares he is on the speaker's bureau for, and gets grant/research support from, Amgen and Novartis. Eitan Amir, Alberto Ocaña and Bostjan Seruga declare no competing interests.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Amir, E., Ocaña, A., Seruga, B. et al. Zoledronic acid for breast cancer therapy-induced bone loss. Nat Rev Clin Oncol 7, 187–188 (2010). https://doi.org/10.1038/nrclinonc.2010.19

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1038/nrclinonc.2010.19

This article is cited by

Search

Quick links

Nature Briefing: Cancer

Sign up for the Nature Briefing: Cancer newsletter — what matters in cancer research, free to your inbox weekly.

Get what matters in cancer research, free to your inbox weekly. Sign up for Nature Briefing: Cancer