Zoledronate, Vitamin D, and Calcium With or Without Strontium 89 or Samarium 153 in Preventing or Delaying Bone Problems in Patients With Bone Metastases From Prostate Cancer, Lung Cancer, or Breast Cancer

This study is ongoing, but not recruiting participants.
Sponsor:
Collaborator:
Information provided by (Responsible Party):
Radiation Therapy Oncology Group
ClinicalTrials.gov Identifier:
NCT00365105
First received: August 16, 2006
Last updated: December 19, 2013
Last verified: December 2013
  Purpose

RATIONALE: Zoledronate, vitamin D and calcium may prevent or delay bone pain and other symptoms caused by bone metastases. It is not yet known whether giving zoledronate together with vitamin D and calcium is more effective with or without strontium 89 or samarium 153 in treating patients with bone metastases from prostate cancer, lung cancer, or breast cancer.

PURPOSE: This randomized phase III trial is studying zoledronate, vitamin D, and calcium to see how well they work compared to zoledronate, vitamin D, calcium, and either strontium 89 or samarium 153 in preventing or delaying bone problems in patients with bone metastases from prostate cancer, lung cancer, or breast cancer.


Condition Intervention Phase
Breast Cancer
Lung Cancer
Metastatic Cancer
Pain
Prostate Cancer
Dietary Supplement: calcium carbonate
Dietary Supplement: calcium citrate
Dietary Supplement: calcium glucarate
Dietary Supplement: vitamin D
Drug: calcium gluconate
Drug: zoledronic acid
Radiation: samarium Sm 153 lexidronam pentasodium
Radiation: strontium chloride Sr 89
Phase 3

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Supportive Care
Official Title: Randomized Phase III Trial to Evaluate Radiopharmaceuticals and Zoledronic Acid in the Palliation of Osteoblastic Metastases From Lung, Breast, and Prostate Cancer

Resource links provided by NLM:


Further study details as provided by Radiation Therapy Oncology Group:

Primary Outcome Measures:
  • Time to development of a malignant skeletal-related events (SRE) [ Time Frame: From randomization to date of SRE development ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • SRE rate at 1 year [ Time Frame: From randomization to 1 year ] [ Designated as safety issue: No ]
  • Overall survival [ Time Frame: From randomization to date of death or last follow-up. Analysis occurs at the same time as the primary outcome. ] [ Designated as safety issue: No ]
  • Changes in quality of life as measured by FACT-G [ Time Frame: From pre-treatment to 1 year ] [ Designated as safety issue: No ]
  • Changes in pain control as measured by Brief Pain Inventory (BPI) [ Time Frame: From pre-treatment to 1 year ] [ Designated as safety issue: No ]
  • Utility and cost effectiveness of the use of radiopharmaceuticals and bisphosphonates as measured by the EuroQol-5 Dimension (EQ-5D) [ Time Frame: From pre-treatment to 1 year ] [ Designated as safety issue: No ]

Enrollment: 261
Study Start Date: July 2006
Primary Completion Date: January 2012 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: Arm I
Patients receive zoledronate IV over 15 minutes once a month. Patients also receive oral vitamin D and oral calcium once daily. Treatment continues in the absence of disease progression or unacceptable toxicity.
Dietary Supplement: calcium carbonate
Zoledronic acid given IV; vitamin D and calcium given orally
Dietary Supplement: calcium citrate
Zoledronic acid given IV; vitamin D and calcium given orally
Dietary Supplement: calcium glucarate
Zoledronic acid given IV; vitamin D and calcium given orally
Dietary Supplement: vitamin D
Zoledronic acid given IV; vitamin D and calcium given orally
Drug: calcium gluconate
Zoledronic acid given IV; vitamin D and calcium given orally
Drug: zoledronic acid
Zoledronic acid given IV; vitamin D and calcium given orally
Experimental: Arm II
Patients receive zoledronate, vitamin D, and calcium as in arm I. Within 6 weeks of beginning study treatment, patients also receive a single dose of either strontium chloride Sr 89 IV or samarium Sm 153 lexidronam pentasodium IV.
Dietary Supplement: calcium carbonate
Zoledronic acid given IV; vitamin D and calcium given orally
Dietary Supplement: calcium citrate
Zoledronic acid given IV; vitamin D and calcium given orally
Dietary Supplement: calcium glucarate
Zoledronic acid given IV; vitamin D and calcium given orally
Dietary Supplement: vitamin D
Zoledronic acid given IV; vitamin D and calcium given orally
Drug: calcium gluconate
Zoledronic acid given IV; vitamin D and calcium given orally
Drug: zoledronic acid
Zoledronic acid given IV; vitamin D and calcium given orally
Radiation: samarium Sm 153 lexidronam pentasodium
Given IV
Radiation: strontium chloride Sr 89
Given IV

Detailed Description:

OBJECTIVES:

Primary

  • Compare the efficacy of zoledronate, vitamin D, and calcium with or without strontium chloride Sr 89 or samarium Sm 153 lexidronam pentasodium, in terms of preventing or delaying the time to development of malignant skeletal-related events (SREs) (defined as a pathological bone fracture, spinal cord compression, surgery to bone, or radiation to bone) in patients with bone metastases secondary to prostate, lung, or breast cancer.

Secondary

  • Compare the rate of SREs at 1 year in patients treated with these regimens.
  • Compare overall survival of patients treated with these regimens.
  • Compare quality of life of patients treated with these regimens.
  • Compare the effect of these regimens on pain control in these patients.
  • Evaluate resource utilization and cost effectiveness of these regimens.

OUTLINE: This is a randomized, open-label, multicenter study. Patients are stratified according to primary disease site (prostate vs breast vs lung) and number of bone metastases (≤ 2 vs > 2). Patients are randomized to 1 of 2 treatment arms.

  • Arm I: Patients receive zoledronate IV over 15 minutes once a month. Patients also receive oral vitamin D and oral calcium once daily. Treatment continues in the absence of disease progression or unacceptable toxicity.
  • Arm II: Patients receive zoledronate, vitamin D, and calcium as in arm I. Within 6 weeks of beginning study treatment, patients also receive a single dose of either strontium chloride Sr 89 IV or samarium Sm 153 lexidronam pentasodium IV.

Quality of life and pain are assessed at baseline and then at 1, 3, 6, and 12 months from start of protocol treatment.

After completion of study treatment, patients are followed every 6 months.

PROJECTED ACCRUAL: A total of 352 patients will be accrued for this study.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

DISEASE CHARACTERISTICS:

  • Histologically or cytologically confirmed lung, breast, or prostate cancer
  • Bone metastases, meeting both of the following criteria:

    • Must be visible on bone scan performed within the past 4 weeks
    • No painful bone metastases unless successfully treated (i.e., by external-beam irradiation) prior to study entry AND the patient has stable pain* for at least 2 weeks after that treatment NOTE: *Stable pain is defined as a patient response of 1, 2, or 3 on Questions 4 and 5 of The Brief Pain Inventory (BPI)
  • No untreated or symptomatic brain metastases
  • No spinal cord compression
  • Hormone receptor status not specified

PATIENT CHARACTERISTICS:

  • Zubrod performance status (PS) 0-2 (for patients with primary breast or prostate cancer) OR Zubrod PS 0-1 (for patients with primary lung cancer)
  • White blood cell count (WBC) ≥ 2,400/mm³
  • Absolute neutrophil count ≥ 1,800/mm³
  • Platelet count ≥ 60,000/mm³
  • Hemoglobin ≥ 8.0 g/dL (transfusion allowed)
  • Creatinine < 3.0 mg/dL
  • Bilirubin < 2.5 mg/dL
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • No uncontrolled congestive heart failure within the past 6 months
  • No hypertension refractory to treatment within the past 6 months
  • No symptomatic coronary artery disease within the past 6 months
  • No current, active dental problems within the past 4 weeks, including any of the following:

    • Infection of the teeth or jawbone (maxilla or mandible)
    • Dental or fixture trauma
    • Prior or current diagnosis of osteonecrosis of the jaw
    • Exposed bone in the mouth
    • Slow healing after dental procedures
  • No known AIDS

    • HIV testing is not required

PRIOR CONCURRENT THERAPY:

  • See Disease Characteristics
  • Prior oral bisphosphonate therapy (i.e. alendronate sodium or similar) allowed

    • No prior IV bisphosphonates for a treatment duration of > 6 months
  • At least 2 weeks since prior calcitonin, mithramycin, or gallium nitrate
  • At least 2 weeks since prior external-beam radiotherapy
  • At least 6 weeks since prior and no concurrent dental surgery (e.g., extractions or implants)
  • No prior radioisotope therapy for bone metastasis
  • Concurrent systemic chemotherapy* or hormonal therapy allowed

    • Chemotherapy and/or hormonal therapy should not be changed within 14 days prior to start of protocol treatment (arm I)
  • No other concurrent bisphosphonate NOTE: *Chemotherapy must be held 2 weeks before and for at least 2 weeks after radiopharmaceutical administration (arm II)
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00365105

  Hide Study Locations
Locations
United States, Alabama
Providence Cancer Center at Providence Hospital
Mobile, Alabama, United States, 36608
United States, California
Roy and Patricia Disney Family Cancer Center at Providence Saint Joseph Medical Center
Burbank, California, United States, 91505
Mercy Cancer Center at Mercy San Juan Medical Center
Carmichael, California, United States, 95608
USC/Norris Comprehensive Cancer Center and Hospital
Los Angeles, California, United States, 90089-9181
Robert and Beverly Lewis Family Cancer Care Center at Pomona Valley Hospital Medical Center
Pomona, California, United States, 91767
Radiation Oncology Center - Roseville
Roseville, California, United States, 95661
Radiological Associates of Sacramento Medical Group, Incorporated
Sacramento, California, United States, 95815
General Robert Huyser Cancer Center at David Grant Medical Center
Travis AFB, California, United States, 94535-1800
United States, Florida
Michael and Dianne Bienes Comprehensive Cancer Center at Holy Cross Hospital
Fort Lauderdale, Florida, United States, 33308
Integrated Community Oncology Network at Southside Cancer Center
Jacksonville, Florida, United States, 32207
Baptist Cancer Institute - Jacksonville
Jacksonville, Florida, United States, 32207
Integrated Community Oncology Network
Jacksonville Beach, Florida, United States, 32250
Baptist Medical Center South
Jascksonville, Florida, United States, 32258
Miami Cancer Center at Mercy Hospital
Miami, Florida, United States, 33133
CCOP - Mount Sinai Medical Center
Miami Beach, Florida, United States, 33140
Integrated Community Oncology Network - Orange Park
Orange Park, Florida, United States, 32073
Florida Cancer Center - Palatka
Palatka, Florida, United States, 32177
Bay Medical
Panama City, Florida, United States, 32401
Flagler Cancer Center
Saint Augustine, Florida, United States, 32086
H. Lee Moffitt Cancer Center and Research Institute at University of South Florida
Tampa, Florida, United States, 33612-9497
United States, Georgia
John B. Amos Cancer Center
Columbus, Georgia, United States, 31904
Northeast Georgia Medical Center
Gainesville, Georgia, United States, 30501
United States, Illinois
Northwest Community Hospital
Arlington Heights, Illinois, United States, 60005
Good Samaritan Cancer Care Center at Advocate Good Samaritan Hospital
Downers Grove, Illinois, United States, 60515-1500
Ingalls Cancer Care Center at Ingalls Memorial Hospital
Harvey, Illinois, United States, 60426
Veterans Affairs Medical Center - Hines
Hines, Illinois, United States, 60141
Advocate Christ Medical Center
Oak Lawn, Illinois, United States, 60453-2699
Advocate Lutheran General Cancer Care Center
Park Ridge, Illinois, United States, 60068-1174
Oncology Hematology Associates of Central Illinois, PC - Peoria
Peoria, Illinois, United States, 61615
Cancer Institute at St. John's Hospital
Springfield, Illinois, United States, 62702
CCOP - Carle Cancer Center
Urbana, Illinois, United States, 61801
United States, Indiana
Center for Cancer Care at Goshen General Hospital
Goshen, Indiana, United States, 46526
Cancer Center at Ball Memorial Hospital
Muncie, Indiana, United States, 47303-3499
CCOP - Northern Indiana CR Consortium
South Bend, Indiana, United States, 46601
United States, Iowa
McFarland Clinic, PC
Ames, Iowa, United States, 50010
CCOP - Iowa Oncology Research Association
Des Moines, Iowa, United States, 50309
Mercy Cancer Center at Mercy Medical Center - Des Moines
Des Moines, Iowa, United States, 50314
Medical Oncology and Hematology Associates at John Stoddard Cancer Center
Des Moines, Iowa, United States, 50309
John Stoddard Cancer Center at Iowa Methodist Medical Center
Des Moines, Iowa, United States, 50309
Medical Oncology and Hematology Associates at Mercy Cancer Center
Des Moines, Iowa, United States, 50314
Siouxland Hematology-Oncology Associates, LLP
Sioux City, Iowa, United States, 51101
United States, Kansas
Lawrence Memorial Hospital
Lawrence, Kansas, United States, 66044
CCOP - Wichita
Wichita, Kansas, United States, 67214
United States, Kentucky
Central Baptist Hospital
Lexington, Kentucky, United States, 40503-9985
United States, Louisiana
Tulane Cancer Center Office of Clinical Research
Alexandria, Louisiana, United States, 71315-3198
United States, Maine
Central Maine Comprehensive Cancer Center at Central Maine Medical Center
Lewiston, Maine, United States, 04240
United States, Maryland
St. Agnes Hospital Cancer Center
Baltimore, Maryland, United States, 21229
United States, Massachusetts
Hudner Oncology Center at Saint Anne's Hospital - Fall River
Fall River, Massachusetts, United States, 02721
Cape Cod Hospital
Hyannis, Massachusetts, United States, 02601
United States, Michigan
Saint Joseph Mercy Cancer Center
Ann Arbor, Michigan, United States, 48106-0995
Oakwood Cancer Center at Oakwood Hospital and Medical Center
Dearborn, Michigan, United States, 48123-2500
Josephine Ford Cancer Center at Henry Ford Hospital
Detroit, Michigan, United States, 48202
Hurley Medical Center
Flint, Michigan, United States, 48503
Genesys Hurley Cancer Institute
Flint, Michigan, United States, 48503
Van Elslander Cancer Center at St. John Hospital and Medical Center
Grosse Pointe Woods, Michigan, United States, 48236
Dickinson County Healthcare System
Iron Mountain, Michigan, United States, 49801
West Michigan Cancer Center
Kalamazoo, Michigan, United States, 49007-3731
Bronson Methodist Hospital
Kalamazoo, Michigan, United States, 49007
Sparrow Regional Cancer Center
Lansing, Michigan, United States, 48912-1811
St. John Macomb Hospital
Warren, Michigan, United States, 48093
United States, Minnesota
CentraCare Clinic - River Campus
Saint Cloud, Minnesota, United States, 56303
United States, Mississippi
Regional Cancer Center at Singing River Hospital
Pascagoula, Mississippi, United States, 39581
United States, Missouri
CCOP - Kansas City
Kansas City, Missouri, United States, 64131
Truman Medical Center - Hospital Hill
Kansas City, Missouri, United States, 64108
Hulston Cancer Center at Cox Medical Center South
Springfield, Missouri, United States, 65807
St. John's Regional Health Center
Springfield, Missouri, United States, 65804
United States, Montana
CCOP - Montana Cancer Consortium
Billings, Montana, United States, 59101
Northern Rockies Radiation Oncology Center
Billings, Montana, United States, 59101
Billings Clinic - Downtown
Billings, Montana, United States, 59107-7000
Great Falls Clinic - Main Facility
Great Falls, Montana, United States, 59405
United States, Nebraska
Good Samaritan Cancer Center at Good Samaritan Hospital
Kearney, Nebraska, United States, 68848-1990
United States, New Jersey
Princeton Radiation Oncology Center
Jamesburg, New Jersey, United States, 08831
Fox Chase Virtua Health Cancer Program at Virtua Memorial Hospital Marlton
Marlton, New Jersey, United States, 08053
University Medical Center at Princeton
Princeton, New Jersey, United States, 08540-3298
Franklin & Edith Scarpa Regional Cancer Center at South Jersey Healthcare
Vineland, New Jersey, United States, 08360
Cancer Institute of New Jersey at Cooper - Voorhees
Voorhees, New Jersey, United States, 08043
United States, New Mexico
New Mexico Cancer Center
Albuquerque, New Mexico, United States, 87109
United States, New York
New York Methodist Hospital
Brooklyn, New York, United States, 11215
Sands Cancer Center
Canandiaqua, New York, United States, 14424
Fitzpatrick Cancer Center at Champlain Valley Physicians Hospital Medical Center
Plattsburgh, New York, United States, 12901
Lipson Cancer and Blood Center at Rochester General Hospital
Rochester, New York, United States, 14621
Highland Hospital of Rochester
Rochester, New York, United States, 14620
James P. Wilmot Cancer Center at University of Rochester Medical Center
Rochester, New York, United States, 14642
University Radiation Oncology at Parkridge Hospital
Rochester, New York, United States, 14626
United States, North Carolina
Mission Hospitals - Memorial Campus
Asheville, North Carolina, United States, 28801
Presbyterian Cancer Center at Presbyterian Hospital
Charlotte, North Carolina, United States, 28233-3549
Wayne Radiation Oncology
Goldsboro, North Carolina, United States, 27534
United States, North Dakota
Trinity CancerCare Center
Minot, North Dakota, United States, 58701
United States, Ohio
McDowell Cancer Center at Akron General Medical Center
Akron, Ohio, United States, 44307
Summa Center for Cancer Care at Akron City Hospital
Akron, Ohio, United States, 44309-2090
Radiation Oncology Center
Alliance, Ohio, United States, 44601
Barberton Citizens Hospital
Barberton, Ohio, United States, 44203
Mercy Cancer Center at Mercy Medical Center
Canton, Ohio, United States, 44708
Adena Regional Medical Center
Chillicothe, Ohio, United States, 45601
CCOP - Columbus
Columbus, Ohio, United States, 43215
David L. Rike Cancer Center at Miami Valley Hospital
Dayton, Ohio, United States, 45409
CCOP - Dayton
Dayton, Ohio, United States, 45420
Samaritan North Cancer Care Center
Dayton, Ohio, United States, 45415
Good Samaritan Hospital
Dayton, Ohio, United States, 45406
Grandview Hospital
Dayton, Ohio, United States, 45405
Middletown Regional Hospital
Franklin, Ohio, United States, 45005-1066
Charles F. Kettering Memorial Hospital
Kettering, Ohio, United States, 45429
MedCentral - Mansfield Hospital
Mansfield, Ohio, United States, 44903
Cancer Care Center, Incorporated
Salem, Ohio, United States, 44460
UVMC Cancer Care Center at Upper Valley Medical Center
Troy, Ohio, United States, 45373-1300
Cancer Treatment Center
Wooster, Ohio, United States, 44691
United States Air Force Medical Center - Wright-Patterson
Wright-Patterson Afb, Ohio, United States, 45433-5529
Ruth G. McMillan Cancer Center at Greene Memorial Hospital
Xenia, Ohio, United States, 45385
United States, Oklahoma
Natalie Warren Bryant Cancer Center at St. Francis Hospital
Tulsa, Oklahoma, United States, 74136
United States, Pennsylvania
Rosenfeld Cancer Center at Abington Memorial Hospital
Abington, Pennsylvania, United States, 19001
UPMC Cancer Center at Beaver Medical Center
Beaver, Pennsylvania, United States, 15009
UPMC Cancer Center at Jefferson Regional Medical Center
Clairton, Pennsylvania, United States, 15025
Northeast Radiation Oncology Center
Dunmore, Pennsylvania, United States, 18512
UPMC Cancer Center - Arnold Palmer Pavilion
Greensburg, Pennsylvania, United States, 15601
UPMC Cancer Center at the John P. Murtha Pavilion
Johnstown, Pennsylvania, United States, 15901
UPMC Cancer Center at UPMC McKeesport
McKeesport, Pennsylvania, United States, 15132
UPMC - Moon
Moon Township, Pennsylvania, United States, 15108
UPMC Cancer Center - Natrona Heights
Natrona Heights, Pennsylvania, United States, 15065
Jameson Memorial Hospital - North Campus
New Castle, Pennsylvania, United States, 16105
UPMC Cancer Center at Magee-Womens Hospital
Pittsburgh, Pennsylvania, United States, 15213
UPMC Cancer Center at UPMC Presbyterian
Pittsburgh, Pennsylvania, United States, 15213
UPMC Cancer Center at UPMC Passavant
Pittsburgh, Pennsylvania, United States, 15237
UPMC Cancer Center at UPMC St. Margaret
Pittsburgh, Pennsylvania, United States, 15215
UPMC - Shadyside
Pittsburgh, Pennsylvania, United States, 15213-2582
UPMC Cancer Center - Upper St. Clair
Pittsburgh, Pennsylvania, United States, 15243
UPMC Cancer Center at UPMC Northwest
Seneca, Pennsylvania, United States, 16346
Mount Nittany Medical Center
State College, Pennsylvania, United States, 16803
UPMC Cancer Center - Uniontown
Uniontown, Pennsylvania, United States, 15401
Washington Hospital Cancer Center
Washington, Pennsylvania, United States, 15301
York Cancer Center at Apple Hill Medical Center
York, Pennsylvania, United States, 17405
United States, South Carolina
Hollings Cancer Center at Medical University of South Carolina
Charleston, South Carolina, United States, 29425
CCOP - Greenville
Greenville, South Carolina, United States, 29615
United States, Utah
Jon and Karen Huntsman Cancer Center at Intermountain Medical Center
Murray, Utah, United States, 84157
Dixie Regional Medical Center - East Campus
Saint George, Utah, United States, 84770
Utah Cancer Specialists at UCS Cancer Center
Salt Lake City, Utah, United States, 84106
LDS Hospital
Salt Lake City, Utah, United States, 84143
United States, Washington
St. Francis Hospital
Federal Way, Washington, United States, 98003
Good Samaritan Cancer Center
Puyallup, Washington, United States, 98372
CCOP - Virginia Mason Research Center
Seattle, Washington, United States, 98101
CCOP - Northwest
Tacoma, Washington, United States, 98405
MultiCare Regional Cancer Center at Tacoma General Hospital
Tacoma, Washington, United States, 98405
Franciscan Cancer Center at St. Joseph Medical Center
Tacoma, Washington, United States, 98405-3004
North Star Lodge Cancer Center at Yakima Valley Memorial Hospital
Yakima, Washington, United States, 98902
United States, Wisconsin
Theda Care Cancer Institute
Appleton, Wisconsin, United States, 54911
Bellin Memorial Hospital
Green Bay, Wisconsin, United States, 54301
Riverview UW Cancer Center at Riverview Hospital
Wisconsin Rapids, Wisconsin, United States, 54494
United States, Wyoming
Welch Cancer Center at Sheridan Memorial Hospital
Sheridan, Wyoming, United States, 82801
Sponsors and Collaborators
Radiation Therapy Oncology Group
Investigators
Study Chair: Michael J. Seider, MD, PhD, FACR Summa Center for Cancer Care at Akron City Hospital
  More Information

Additional Information:
Publications:
Seider MJ, Shook S, Langer CJ, et al.: Randomized phase III trial to evaluate radiopharmaceuticals and zoledronic acid in the palliation of osteoblastic metastases from lung, breast, and prostate cancer: report of RTOG 0517. [Abstract] J Clin Oncol 30 (Suppl 15): A-TPS9150, 2012.

Responsible Party: Radiation Therapy Oncology Group
ClinicalTrials.gov Identifier: NCT00365105     History of Changes
Other Study ID Numbers: RTOG 0517, CDR0000491233, NCI-2009-00727
Study First Received: August 16, 2006
Last Updated: December 19, 2013
Health Authority: United States: Federal Government

Keywords provided by Radiation Therapy Oncology Group:
pain
bone metastases
extensive stage small cell lung cancer
recurrent breast cancer
stage IV breast cancer
recurrent non-small cell lung cancer
stage IV non-small cell lung cancer
recurrent prostate cancer
stage IV prostate cancer

Additional relevant MeSH terms:
Breast Neoplasms
Lung Neoplasms
Neoplasm Metastasis
Prostatic Neoplasms
Breast Diseases
Genital Diseases, Male
Genital Neoplasms, Male
Lung Diseases
Neoplasms
Neoplasms by Site
Neoplastic Processes
Pathologic Processes
Prostatic Diseases
Respiratory Tract Diseases
Respiratory Tract Neoplasms
Skin Diseases
Thoracic Neoplasms
Urogenital Neoplasms
Calcium Carbonate
Calcium, Dietary
Diphosphonates
Ergocalciferols
Samarium ethylenediaminetetramethylenephosphonate
Vitamin D
Vitamins
Zoledronic acid
Analgesics
Analgesics, Non-Narcotic
Antacids
Bone Density Conservation Agents

ClinicalTrials.gov processed this record on October 21, 2014