What is your approach to the use of denosumab in patients with metastatic breast cancer with bony involvement?  

Do you extrapolate the results of OPTIMIZE-2 and CALGB 70604 showing that an every 12 week dosing of zolendronic acid is noninferior to every 3 weeks? If so, do you start this schedule with the first dose or after a "lead in" period?

Answer from: Medical Oncologist at Academic Institution