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Brief Title: Comparison of Two Schedules of Zoledronic Acid in Treating Patients With Breast Cancer That Has Spread to the Bone
Official Title: Cost-Effective Use of Bisphosphonates in Metastatic Bone Disease - A Comparison of Bone Marker Directed Zoledronic Acid Therapy to a Standard Schedule
Study ID: NCT00458796
Brief Summary: RATIONALE: Zoledronic acid may help decrease the risk of broken bones, bone pain, and other symptoms caused by bone metastases. It may also help patients live more comfortably. PURPOSE: This randomized clinical trial is studying different schedules of zoledronic acid to compare how well they work in treating patients with breast cancer that has spread to the bone.
Detailed Description: OBJECTIVES: Primary * Compare the frequency and timing of serious related events (e.g., fractures, radiotherapy to bone, hypercalcemia of malignancy, orthopedic surgery, and spinal cord compression) in patients with advanced breast cancer metastatic to the bone treated with bone marker-directed schedule vs standard schedule zoledronic acid. Secondary * Compare the quality of life of patients treated with these regimens. * Compare the clinical burden of skeletal complications in these patients. * Compare pain, performance status, and analgesic use (PPA score) in these patients. * Compare the incidence of new bone metastases in these patients. * Compare overall survival of these patients. * Compare bisphosphonate use and expenditure on administration in these patients. OUTLINE: This is an open-label, randomized, controlled, parallel-group, multicenter study. Patients are stratified according to treatment center, gender, type of concurrent systemic therapy at study entry (endocrine therapy \[with or without trastuzumab (Herceptin\^®)\] vs chemotherapy \[with or without trastuzumab\] vs trastuzumab alone vs chemotherapy and endocrine therapy \[with or without trastuzumab\] vs no systemic anticancer treatment), prior skeletal-related event (yes vs no), duration of bisphosphonate use for metastatic disease prior to study entry (4-6 months vs 6-12 months), type of metastases present at study entry (bone only vs bone and soft tissue vs bone and visceral metastases vs bone, soft tissue, and visceral metastases). Patients are randomized to 1 of 2 treatment arms. * Arm I (standard schedule): Patients receive zoledronic acid IV over 15 minutes once every 3-4 weeks for 24 months. * Arm II (bone marker-directed schedule): Patients receive zoledronic acid IV over 15 minutes once every 3-4, 8-9, or 15-16 weeks (based on serum N-telopeptide:creatinine ratio) for 24 months. Quality of life is assessed at baseline and at 3, 6, 9, 12, 18, and 24 months. After completion of study therapy, patients are followed periodically for up to 3 years. PROJECTED ACCRUAL: A total of 1,500 patients will be accrued for this study.
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: No
Royal Bournemouth Hospital, Bournemouth, England, United Kingdom
Derbyshire Royal Infirmary, Derby, England, United Kingdom
Doncaster Royal Infirmary, Doncaster, England, United Kingdom
University Hospital of North Durham, Durham, England, United Kingdom
Diana Princess of Wales Hospital, Grimsby, England, United Kingdom
St. Luke's Cancer Centre at Royal Surrey County Hospital, Guildford, England, United Kingdom
Huddersfield Royal Infirmary, Huddersfield, West Yorks, England, United Kingdom
Royal Liverpool University Hospital, Liverpool, England, United Kingdom
Saint Bartholomew's Hospital, London, England, United Kingdom
Christie Hospital, Manchester, England, United Kingdom
Withington Hospital, Manchester, England, United Kingdom
Clatterbridge Centre for Oncology, Merseyside, England, United Kingdom
George Eliot Hospital, Nuneaton, England, United Kingdom
Dorset Cancer Centre, Poole Dorset, England, United Kingdom
Scunthorpe General Hospital, Scunthorpe, England, United Kingdom
Cancer Research Centre at Weston Park Hospital, Sheffield, England, United Kingdom
Royal Shrewsbury Hospital, Shrewsbury, England, United Kingdom
Solihull Hospital, Solihull, England, United Kingdom
Southampton General Hospital, Southampton, England, United Kingdom
South Warwickshire Hospital, Warwick, Warwickshire, England, United Kingdom
Southend University Hospital NHS Foundation Trust, Westcliff-On-Sea, England, United Kingdom
Royal Hampshire County Hospital, Winchester, England, United Kingdom
Western Infirmary, Glasgow, Scotland, United Kingdom
Beatson West of Scotland Cancer Centre, Glasgow, Scotland, United Kingdom
Hairmyres Hospital, Glasgow, Scotland, United Kingdom
Crosshouse Hospital, Kilmarnock, Scotland, United Kingdom
Velindre Cancer Center at Velindre Hospital, Cardiff, Wales, United Kingdom
Withybush General Hospital, Haverfordwest, Wales, United Kingdom
Royal Gwent Hospital, Newport Gwent, Wales, United Kingdom
South West Wales Cancer Institute, Swansea, Wales, United Kingdom
Name: Robert E. Coleman, MD, FRCP
Affiliation: Cancer Research Centre at Weston Park Hospital
Role: STUDY_CHAIR