New generation of bisphosphonates: broad clinical utility in breast and prostate cancer

Cancer treatment-induced bone loss is an emerging problem for patients with breast and prostate cancer, who are often treated with cancer therapies earlier in the disease process. Bone loss associated with cancer therapy can also progress rapidly and may cause significant morbidity in these patients. Many patients with metastatic prostate or breast cancer develop bone metastases and subsequent skeletal-related events. Studies suggest that bisphosphonates can maintain bone health when introduced early in the continuum of cancer care. They have shown efficacy in the prevention of bone loss and the more potent i.v. bisphosphonate, zoledronic acid, has prevented bone loss in addition to increasing BMD in prostate cancer patients with cancer treatment-induced bone loss. Intravenous zoledronic acid or pamidronate can be considered the standard of care for the treatment of osteolytic bone metastases in breast cancer. Clinical trials addressing the treatment of bone metastases related to prostate cancer have shown zoledronic acid to be the only bisphosphonate to have a significant positive effect on skeletal-related events.