At EBCC , the ZOOM data was highlighted http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(13)70297-3/fulltext. For years clinicians have remained concerned that we are overusing anti-resorptive agents in advanced breast cancer with bone metastases. This data showed no detriment in outcome with a reduction in the use of zoledronic acid (ZA) to 12 weekly in year 2 of treatment. At the least, this new approach will improve patient convenience , and may impact somewhat on the incidence of osteonecrosis of the jaw (BONJ).
It is speculative as to how to apply this new data to denosumab, which was not assessed in this study. Nevertheless, it is intriguing and not unreasonable to think that a similar result would be seen with denosumab, particularly as it is slightly more effective than ZA in the first instance.
