Bisphosphonates in the prevention of bone metastases: current evidence.

The use of bisphosphonates is well established for the treatment of bone metastases to reduce skeletal complications in patients with breast and other cancers, to provide a better quality of life. More recently, however, there is evidence that these agents may also have antitumor effects. Therefore, the use of bisphosphonates is now being examined in improving overall survival, by potentially reducing metastatic bone disease in particular. To date, three randomized trials have been conducted in over 1,500 women with breast cancer using 1,600 mg clodronate as adjuvant medication. This article evaluates and presents the results of these studies, and reviews current evidence surrounding the prophylactic use of bisphosphonates for skeletal progression of breast cancer.