Bone-Modifying Agents in Metastatic Breast Cancer
- Patients with breast cancer who have evidence of bone metastases should be treated with BMAs. (Strong Recommendation: EB-H)
- One BMA is not recommended over another.
- Options include:
- denosumab, 120 mg subcutaneously, every 4 weeks;
- pamidronate, 90 mg intravenously, every 3–4 weeks; or
- zoledronic acid, 4 mg intravenously, over no less than 15 minutes,
every 12 weeks or every 3–4 weeks.
- The analgesic effects of BMAs (denosumab, pamidronate, or zoledronic acid) are modest. They should not be used alone for bone pain.
(Weak Recommendation: EB-L).
- The current standard of care for supportive care and pain management should be applied. This can include analgesia, adjunct therapies, radiotherapy, surgery, systemic anti-cancer therapy, and referral to supportive care and pain management.
- Evidence of a clinically meaningful benefit is insufficient to support the use of one bone-modifying agent over another.
...BMAs are recommended for patients with meta...
...Route of Administration, Dose, and Sched...