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Systemic Anti-Cancer Therapy Regimen Library

BR Metastatic - zoledronic acid Q12W

Treatment Overview

Cycle 1 (and all further cycles) - 84 days

Cycle length:
84

Consider oral supplementation of at least 500 mg elemental calcium daily and vitamin D equivalent to 400 units daily (e.g. colecalciferol 1.25 mg orally ONCE a month) for the duration of treatment.

Dental check-up recommended prior to starting, and at 6-monthly intervals during treatment.

Patients should be encouraged to maintain good oral hygiene, and report any adverse oral symptoms.

Cycle details

Cycle 1 (and all further cycles) - 84 days

Medication Dose Route Days Max Duration
zoledronic acid * 4 mg intravenous 1 Min: 15 minutes

Consider oral supplementation of at least 500 mg elemental calcium daily and vitamin D equivalent to 400 units daily (e.g. colecalciferol 1.25 mg orally ONCE a month) for the duration of treatment.

Dental check-up recommended prior to starting, and at 6-monthly intervals during treatment.

Patients should be encouraged to maintain good oral hygiene, and report any adverse oral symptoms.

Full details

Cycle 1 (and all further cycles) - 84 days

Day: 1

Medication Dose Route Max duration Details
zoledronic acid * 4 mg intravenous Min: 15 minutes
Instructions:
Consider oral supplementation of at least 500 mg elemental calcium daily and vitamin D equivalent to 400 units daily (e.g. colecalciferol 1.25 mg orally ONCE a month) for the duration of treatment. Dental check-up recommended prior to starting, and at 6-monthly intervals during treatment.

Supportive Care Factors

No supportive care factors specified

References

1. Himelstein, A. Foster, J. J. Khatcheressian et al. 2017. "Effect of longer-interval vs standard dosing of zoledronic acid on skeletal events in patients with bone metastases". JAMA. 2017;317(1):48-58, PMID: 28030702

2. Hortobagyi, G. N., A. Lipton, H. K. Chew, et al. 2014. "Efficacy and safety of continued zoledronic acid every 4 weeks versus every 12 weeks in women with bone metastases from breast cancer: Results of the optimize-2 trial." Journal of Clinical Oncology 32(11):

3. Van Poznak, Catherine, Mark R. Somerfield, William E. Barlow, et al. 2017. "Role of Bone-Modifying Agents in Metastatic Breast Cancer: An American Society of Clinical Oncology–Cancer Care Ontario Focused Guideline Update." Journal of Clinical Oncology 35(35):3978-3986., PMID: 29035643

4. O'Carrigan, B., M. H. Wong, M. L. Willson, et al. 2017. "Bisphosphonates and other bone agents for breast cancer." Cochrane Database Syst Rev 10:CD003474.9, PMID: 29082518

5. Amadori, Dino, Massimo Aglietta, Barbara Alessi, et al. 2013. "Efficacy and safety of 12-weekly versus 4-weekly zoledronic acid for prolonged treatment of patients with bone metastases from breast cancer (ZOOM): a phase 3, open-label, randomised, non-inferiority trial." The Lancet Oncology 14(7):663-670., PMID: 23684411

6. Theriault, R. L., A. Lipton, G. N. Hortobagyi, et al. 1999. "Pamidronate reduces skeletal morbidity in women with advanced breast cancer and lytic bone lesions: a randomized, placebo-controlled trial. Protocol 18 Aredia Breast Cancer Study Group." J.Clin Oncol 17(3):846-854, PMID: 10071275

7. Rosen, L. S., D. H. Gordon, W. Dugan, Jr., et al. 2004. "Zoledronic acid is superior to pamidronate for the treatment of bone metastases in breast carcinoma patients with at least one osteolytic lesion." Cancer 100(1):36-43., PMID: 14692022

* The medicines, doses, combinations, and schedule in this treatment regimen have been carefully reviewed against international best practice guidelines by specialists in medical oncology around New Zealand and this advice has been accepted for publication by Te Aho o Te Kahu (the Cancer Control Agency). Sometimes medicines that are used in routine clinical practice have not been through a formal review process by the NZ Medicines Regulator Medsafe and are therefore considered unapproved or off-label. These medicines are legally able to be prescribed through sections 25 and 29 of the Medicines Act and by obtaining informed consent from patients. All treatment regimens listed on this website have been through robust peer review and are considered an accepted standard of care, whether prescribed through sections 25 or 29 or carrying formal Medsafe Approval.

s29: This symbol indicates that some formulations of the associated medicine are legally only able to be prescribed under section 29 of the Medicines Act. You can see which formulations are section 29 by hovering over the s29 symbol. You can access full medication details from the New Zealand Formulary by clicking on the medication name. Each clinician retains full responsibility for ensuring they have complied with all relevant obligations and requirements of section 29 including obtaining informed patient consent prior to prescribing the applicable medicine.