Dr. Gralow Explains the Side Effects of Zoledronic Acid

Julie R. Gralow, MD, Director, Breast Medical Oncology, Seattle Cancer Care Alliance (SCCA), discusses the side effects associated with the administration of zoledronic acid (Zometa) in the adjuvant setting for postmenopausal patients with breast cancer.

Gralow explains that the administration of zoledronic acid every 6 months does not result in many adverse events, as demonstrated by the ABCSG-12 and ZO-FAST trials. When administering bisphosphonates, it is important to check for renal toxicities; however, when zoledronic acid was administered every 6 months the renal toxicity was not a prominent adverse event.

Osteonecrosis of the jaw (ONJ) is commonly associated with the monthly dose of zoledronic acid that is used to treat bone metastases. This side effect is common for most bisphosphonates. In the 6-month adjuvant trials, the occurrence of ONJ was rare and not widely reported, Gralow states.

For patients receiving a once every 6-month dose of zoledronic acid, the most common side effects were infusion-related reactions. These reactions mimicked those most commonly seen with the flu and generally did not stretch beyond the first infusion, for most patients.