A Phase II Randomized Study of the Effect of Zoledronic Acid Versus Observation on Bone Mineral Density of the Lumbar Spine in Women Who Elect to Undergo Surgery That Results in Removal of Both Ovaries

Inclusion Criteria

DISEASE CHARACTERISTICS:

- Patients who have elected to undergo, or who have undergone (within 8 weeks) a
surgical procedure that results (at minimum) in the absence of both ovaries

- Patients enrolled in the screening arm of GOG-0199 who decide to undergo surgery
are potentially eligible for GOG-0215

- Baseline bone mass density (BMD) T-Score ≥ -1.5 (no more than 1.5 standard deviation
below the mean value for young adults) on both the total lumbar spine (L1-L4 region,
not individual bones) and bilateral hip

- Patients who had/have at least 1 intact ovary at the time of surgery are eligible

- No prior distant metastatic malignant disease within the past 5 years

- Patients treated for stage M1 (any T, any N) diagnosis in the past 5 years are
ineligible

- Patients who achieved a complete response after treatment for rM0 (any T, any N)
within the past 5 years are eligible

PATIENT CHARACTERISTICS:

- Premenopausal*

- Last menstrual cycle occurred < 12 months prior to study enrollment NOTE: *In
unclear cases premenopausal status may be determined by follicle stimulating
hormone level AND must be ≤ 20 U/L

- GOG performance status 0-2

- Creatinine clearance > 60 mL/min

- No clinical or radiological evidence of existing fracture of the lumbar spine or
bilateral hip

- No history of hip of spine fracture with low-intensity trauma or not associated with
trauma

- No uncontrolled seizure disorder associated with falls

- No diseases that influence bone metabolism, including any of the following:

- Paget's disease

- Osteogenesis imperfecta

- Uncontrolled thyroid or parathyroid dysfunction within 12 months prior to study
entry

- No other nonmalignant systemic disease, including any of the following:

- Uncontrolled infection

- Uncontrolled type 2 diabetes mellitus

- Cardiovascular, renal, hepatic, or lung disease that would prevent prolonged
follow-up

- History of thrombosis or thromboembolism allowed

- No known HIV positivity

- No known hypersensitivity to zoledronate or other bisphosphonates

- No psychiatric, psychological, or other conditions that prevent fully informed
consent

- No other active malignancy except nonmelanoma skin cancer

- No history of any medical condition that places the patient at risk for donating
blood for research purposes (e.g., chronic infectious diseases, sever anemia, or
hemophilia)

- Not pregnant

- Negative pregnancy test

- No current active dental problems, including any of the following:

- Infection of the teeth or jawbone (maxilla or mandible)

- Dental or fixture trauma

- Current or prior diagnosis of osteonecrosis of the jaw

- Exposed bone in the mouth

- Slow healing after dental procedures

PRIOR CONCURRENT THERAPY:

- No recent (within 6 weeks) or planned dental or jaw surgery (e.g., extraction or
implants)

- No prior treatment for osteoporosis

- No adjuvant radiotherapy within the past 31 days

- No chemotherapy within the past 30 days

- No prior surgery to the hip or spine

- No prior systemic sodium fluoride for > 3 months during the past 2 years

- No more than 30 days use in the past 12 months and no concurrent tamoxifen,
raloxifene, or any other selective estrogen-receptor modulator (SERM)

- More than 12 months since prior and no concurrent endocrine therapy

- Insulin and/or oral antidiabetic medications allowed

- Thyroid hormone replacement allowed

- More than 12 months since prior and no concurrent estrogen or hormone replacement
therapy (estrogen plus progesterone or estrogen alone)

- Prior or concurrent oral contraceptives allowed

- Systemic (oral) hormone replacement therapy following surgery not allowed

- Vaginal (non-systemic) estrogen allowed

- More than 12 months since prior and no concurrent oral or IV bisphosphonate

- More than 12 months since prior and no concurrent anabolic steroids or growth hormone

- More than 12 months since prior and no concurrent systemic corticosteroids

- Concurrent short term corticosteroid therapy (to prevent/treat
chemotherapy-induced nausea/vomiting) allowed

- More than 6 months since prior and no concurrent Tibolone

- More than 2 weeks since prior and no concurrent drugs known to affect the skeleton
(e.g., calcitonin, mithramycin, or gallium nitrate)

- No concurrent chemotherapy or radiotherapy

- No concurrent aromatase inhibitors

- Concurrent enrollment on protocol GOG-0199 allowed