Medication related osteonecrosis of the jaws associated with targeted therapy as monotherapy and in combination with antiresorptives. A report of 7 cases from the Copenhagen Cohort

Oral Surg Oral Med Oral Pathol Oral Radiol. 2018 Feb;125(2):157-163. doi: 10.1016/j.oooo.2017.10.010. Epub 2017 Nov 6.

Abstract

Objective: The aim of this study was to report cases of medication-related osteonecrosis of the jaws (MRONJ) associated with targeted therapy (TT) with or without concomitant antiresorptive treatment, among the Copenhagen ONJ cohort, which includes all consecutive cases of MRONJ seen in Copenhagen.

Study design: We retrospectively studied the treatment of 204 consecutive patients with MRONJ, seen between January 2010 and May 2016, to identify those associated with TT.

Results: We detected 7 cases of MRONJ associated with TT (3.4%). Four patients received TT only, whereas 3 were concomitantly treated with bisphosphonates (n = 3) and/or denosumab (n = 3). The TT regimens included sunitinib (Sutent) (n = 1), everolimus (Afinitor) (n = 1), erlotinib (Tarceva) (n = 1), bevacizumab (Avastin) (n = 3), dasatinib (Sprycel) (n = 1) and imatinib (Glivec) (n = 1). The MRONJ stage included stages 1 and 2, and mean score on the visual analogue scale for pain in the jaw was 4.0.

Conclusions: Health care providers should be aware of the possibility of MRONJ associated with the TT agents sunitinib, everolimus, and dasatinib and uncommon cancer types, including renal cell carcinoma, non-small-cell lung cancer, glioblastoma, and leukemia, where MRONJ may also occur.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / adverse effects*
  • Bisphosphonate-Associated Osteonecrosis of the Jaw / epidemiology
  • Bisphosphonate-Associated Osteonecrosis of the Jaw / therapy*
  • Bone Density Conservation Agents / adverse effects*
  • Dasatinib / adverse effects
  • Denmark / epidemiology
  • Everolimus / adverse effects
  • Female
  • Humans
  • Indoles / adverse effects
  • Male
  • Middle Aged
  • Neoplasms / drug therapy*
  • Pyrroles / adverse effects
  • Retrospective Studies
  • Sunitinib

Substances

  • Antineoplastic Agents
  • Bone Density Conservation Agents
  • Indoles
  • Pyrroles
  • Everolimus
  • Dasatinib
  • Sunitinib