In this report patients could still get reduced pain & better control of bone resorption from Zometa after ceasing to get benefits from either Pamidronate or Clodronate.
http://www.ncbi.nlm.nih.gov/entrez/q...=pubmed_docsum
Phase II trial evaluating the palliative benefit of second-line zoledronic acid in breast cancer patients with either a skeletal-related event or progressive bone metastases despite first-line bisphosphonate therapy.
I believe Zometa has anticancer activity for some patients in addition to reducing the risk of bone fractures for most.
I base this assumption on personal experience with a single case of non metastatic breast cancer & on a small clinical study on the effect of Zometa in reducing the cancer growth factor VEGF as well as extending progression free survival in metastatic cases(see
http://www.liebertonline.com/doi/abs...ournalCode=jir)
Even though this last study did not show longer overall survival from using Zometa, one can assume that as future metastatic cancer treatments become even better in extending visceral progression free time Zometa might provide a more evident advantage in overall survival time.
In an other article (posted at
http://www.her2support.org/vbulletin...ghlight=zometa) it was demonstrated that maximum benefits from Zometa occur if it is administered before pain sets in.
So a tentative conclusion from both the Phase II trial (above) & the latter study would be to start with Zometa instead of Pamidronate or Clodronate & to start early.