Supplemental Table 3: Explanation of Treatment Attributes

Treatment attribute / Explanation
Time (months) until a complication of bone metastases / A complication of bone metastases could be a fracture, radiation therapy to prevent a fracture and/or to treat bone pain, surgery to the bone to prevent fracture, or increased pressure to the spinal cord. Radiation therapy and pressure to the spinal cord may lead to symptoms such as weakness in the legs, tiredness, burning of the skin and loss of control of the bladder or bowel. Treatment with a bone-targeted agent can help to delay these types of complications.
Time (months) until worsening of pain / Pain due to bone metastases can keep a person from carrying out their usual daily activities such as walking outside and inside activities. Pain can increase in the future but, bone-targeted agents can help to delay the time until the pain worsens.
Risk of osteonecrosis of the jaw (ONJ) / Occurring when the bone in the jaw, inside the mouth, is exposed, usually after a tooth is removed. ONJ can occur even if a person has false teeth and it can be painful and include other symptoms such as numbness, swelling and a feeling of heaviness of the jaw. The condition could improve with treatment, but that healing was not guaranteed.
Risk of renal Impairment / Occurring when the kidneys do not work as well as they should, excess waste can build up in the body and blood, resulting in lack of energy. Assessment of renal impairment requires a blood test and that renal impairment may require changes to the chemotherapy dose that can affect efficacy of treatment.
Mode of administration / Treatments to delay bone complications can be taken as:
-Daily oral tablet, once a day in the morning at least 60 minutes before eating or drinking, not combined with other medicines or vitamins and waiting at least 60 minutes after taking the tablet before lying down.
-Injection every 4 weeks at doctor’s office, hospital or clinic, where a nurse will insert a needle in the skin. Mild pain, redness and swelling might occur at the place where the medicine was injected.
-Infusion every 4 weeks, at doctor’s office, hospital or clinic, where a nurse will insert a needle or install a catheter attached to the bag filled with liquid medicine. The infusion time may take 15 minutes or 120 minutes (2 hours). After the infusion, some people might have flu-like symptoms, such as fever, chills, headache, muscle aches and tiredness, that can last up to 24 hours after each infusion.