Good news, I think! I've been following the several recent posts about Zometa, since my MO wants me to start. I was surprised when she told me that the infusions would be every 3 MONTHS, because the recent posts here suggested that the protocol was every 3 WEEKS. Her reply:
"The original FDA approval was for every 3-4 weeks. There was data several years ago that giving it every 3 months works just as well for solid tumors (which is what prostate cancer is) and is less toxic (Himelstein et al, JAMA 2017). "
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The study she's citing is based on relatively short follow-up. With longer follow-up (over 2 years) there seems to be an advantage to more frequent infusions.
Here's what Fred Saad, one of the foremost experts on this, says:
"And you and I have heard many people say, "Well, maybe we don't need to treat them that intensely. We can maybe spread out the number of doses." And we actually did it in several analyses, and when you dose de-intensify, the risk of these events increases significantly and so, I think in that state, every four weeks remains important... So these patients are at risk of fracturing, of having events, and if you start spreading it out too early, these bone markers come back up and the event rates go up. And we did an analysis looking at different centers in Canada, some that give every three months and some that give every four weeks, and we saw that patients that were getting it every three months that needed it, were actually having almost the same event rate as patients not treated at all.
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