| E.1 Medical condition or disease under investigation | 
| E.1.1 | Medical condition(s) being investigated  | 
| bone metastasis in patients with breast cancer | 
 
 
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| MedDRA Classification | 
| E.1.2 Medical condition or disease under investigation | 
| E.1.2 | Version  | 6.1 | 
 
| E.1.2 | Level  | PT | 
 
| E.1.2 | Classification code  | 10027452 | 
 
 
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| E.1.3 | Condition being studied is a rare disease  |  No  | 
| E.2 Objective of the trial | 
| E.2.1 | Main objective of the trial  | 
| The primary objective is to determine the efficacy  skeletal morbidity rate  of Zometa administered every three months versus Zometa given every 4 weeks in patients with bone metastasis from breast cancers who have been previously treated with Zometa for 9-12 infusions. | 
 
 
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| E.2.2 | Secondary objectives of the trial  | 
| To compare the two arms in respect to the occurrence of other SREs  time and frequency  and in respect to bone pain, analgesic consumption and bone turnover and tumor markers.   proportion of patients experiencing SREs  overall and by event    time to first SRE   annual incidence of any SREs  by event SMR     composite bone pain score according to the Brief Pain inventory/BPI questionnaire  Appendix 1    use of analgesic medications according to the analgesic score  Appendix 2    markers of bone turnover  NTX, PTH  and VEGF  the substuy on the markers will be carried out in a limited number of patients  | 
 
 
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| E.2.3 | Trial contains a sub-study  |  Information not present in EudraCT  | 
| E.3 | Principal inclusion criteria  | 
| Female patients   18 years of age.   Written informed consent given.   Histologically confirmed Stage IV breast cancer with at least one bone metastasis radiologically confirmed.    Life expectancy   1 year.    Treatment with Zometa every 3-4 weeks, for 9-12 infusions over no more than 15 months.   ECOG performance status   2. | 
 
 
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| E.4 | Principal exclusion criteria | 
| More than 3 months since last infusion of Zometa.   Treatments with other bisphosponates than Zometa at any time prior to study entry.   Serum creatinine   3 mg/dL  265  mol/L  or calculated  Cockcroft-Gault formula  creatinine clearance  CLCr    30 mL/min   CrCl     140-age  years   x weight  kg       x 0.85                              72 x serum creatinine  mg/dL     Corrected  adjusted for serum albumin  serum calcium   8 mg/dl  2 mmol/L  or   12 mg/dL   3.0 mmol/L .   Current active dental problem including infection of the teeth or jawbone  maxilla or mandibular ; dental or fixture trauma, or a recurrent or prior diagnosis of osteonecrosis of the jaw  ONJ , of exposed bone in the mouth, or of slow healing after dental procedures.   Recent  within 6 weeks  or planned dental or jaw surgery  e.g. extraction, implants .   Pregnant patients  with a positive pregnancy test prior to study entry  or lactating patients. Women of childbearing potential not using effective methods of birth control  e.g. abstinence, oral contraceptives or implants, IUD, vaginal diaphragm or sponge, or condom with spermicide .    History of non-compliance to medical regimens or potential unreliable behavior.   Known sensitivity to study drug s  or class of study drug s .   Patients with severe medical condition s  that in the view of the investigator prohibits participation in the study | 
 
 
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| E.5 End points | 
| E.5.1 | Primary end point(s) | 
| The primary efficacy endpoint of this study is the annual overall Skeletal Morbidity Rate  SMR . | 
 
 
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| E.6 and E.7 Scope of the trial | 
| E.6 | Scope of the trial | 
| E.6.1 | Diagnosis |  No  | 
| E.6.2 | Prophylaxis |  No  | 
| E.6.3 | Therapy |  No  | 
| E.6.4 | Safety |  Yes  | 
| E.6.5 | Efficacy |  Yes  | 
| E.6.6 | Pharmacokinetic |  No  | 
| E.6.7 | Pharmacodynamic |  No  | 
| E.6.8 | Bioequivalence |  Information not present in EudraCT  | 
| E.6.9 | Dose response |  No  | 
| E.6.10 | Pharmacogenetic |  Information not present in EudraCT  | 
| E.6.11 | Pharmacogenomic |  No  | 
| E.6.12 | Pharmacoeconomic |  No  | 
| E.6.13 | Others |  Information not present in EudraCT  | 
| E.7 | Trial type and phase | 
| E.7.1 | Human pharmacology (Phase I) |  No  | 
| E.7.1.1 | First administration to humans |  No  | 
| E.7.1.2 | Bioequivalence study |  No  | 
| E.7.1.3 | Other |  No  | 
| E.7.1.3.1 | Other trial type description |  | 
| E.7.2 | Therapeutic exploratory (Phase II) |  No  | 
| E.7.3 | Therapeutic confirmatory (Phase III) |  Yes  | 
| E.7.4 | Therapeutic use (Phase IV) |  No  | 
| E.8 Design of the trial | 
| E.8.1 | Controlled |  Yes  | 
| E.8.1.1 | Randomised |  Yes  | 
| E.8.1.2 | Open |  Yes  | 
| E.8.1.3 | Single blind |  No  | 
| E.8.1.4 | Double blind  |  No  | 
| E.8.1.5 | Parallel group |  Yes  | 
| E.8.1.6 | Cross over  |  No  | 
| E.8.1.7 | Other |  Yes  | 
| E.8.1.7.1 | Other trial design description | 
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| E.8.2 |  Comparator of controlled trial | 
| E.8.2.1 | Other medicinal product(s) |  No  | 
| E.8.2.2 | Placebo  |  No  | 
| E.8.2.3 | Other |  Yes  | 
| E.8.2.3.1 | Comparator description | 
| stesso farmaco e dosaggio, diversa frequenza sommi | 
 
 
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| E.8.3 | 
                                The trial involves single site in the Member State concerned
                             |  No  | 
| E.8.4 |  The trial involves multiple sites in the Member State concerned  |  Yes  | 
| E.8.5 | The trial involves multiple Member States |  No  | 
| E.8.6 Trial involving sites outside the EEA | 
| E.8.6.1 | Trial being conducted both within and outside the EEA |  No  | 
| E.8.6.2 | Trial being conducted completely outside of the EEA |  Information not present in EudraCT  | 
| E.8.7 | Trial has a data monitoring committee |  Information not present in EudraCT  | 
| E.8.8 | 
                        Definition of the end of the trial and justification where it is not the last
                        visit of the last subject undergoing the trial
                     |  | 
| E.8.9 Initial estimate of the duration of the trial | 
| E.8.9.1 | In the Member State concerned years | 2 | 
| E.8.9.1 | In the Member State concerned months | 6 | 
| E.8.9.1 | In the Member State concerned days |  | 
| E.8.9.2 | In all countries concerned by the trial years | 2 | 
| E.8.9.2 | In all countries concerned by the trial months | 6 |