Osteonecrosis of jaw after antiangiogenic agent administration in a renal cell carcinoma patient

Risk profile for antiangiogenic agent-related osteonecrosis of the jaws

“…The mean age of patients with AARONJ was 59.7 years, and the median, 60 years, with minimum age of 47 years ( 3 ) and maximum age of 79 years. ( 4 ) In respect to sex, 11 patients were male (58%) ( 2 – 4 , 10 , 14 – 17 , 19 ) and 8 were female (42%); ( 1 , 5 , 6 , 8 , 9 , 12 , 13 , 16 , 18 ) different from what the AAOMS reported in 2014. ( 7 ) The race of patients was not described in the articles and, therefore, was excluded from the final result table.…”

“…In this review, we observed that antiangiogenic agents were prescribed for metastatic cancer in 63.2% (n=12) of cases, ( 1 – 5 , 10 – 13 , 17 , 18 ) whereas kidney cancer was the most prevalent diagnosis (n=6; 31.6%), ( 4 , 6 , 11 , 13 , 15 , 17 ) followed by colon cancer, with 15.8% (n=3). ( 2 , 4 , 5 ) Antiangiogenic agent-related osteonecrosis of the jaws was also described in a non-cancer case of retinal vein thrombosis.…”

“…The most commonly found antiangiogenic agent was bevacizumab, in 58% of cases (n=11), ( 1 – 4 , 9 , 10 , 12 , 14 , 16 , 17 ) followed by sunitinib, in 11% (n=2), ( 13 , 15 ) and the other 31% used aflibercept (n=1), ( 5 ) sorafenib (n=1), ( 20 ) cabozantinib (n=1), ( 18 ) pazopanib (n=1), ( 6 ) sorafenib + sunitinib (n=1), ( 11 ) and bevacizumab + sorafenib (n=1). ( 8 )…”

“…In the selected articles, most were published in Italy, ( 3 – 6 , 10 , 12 , 18 , 19 ) i.e , 39% (n=7), followed by Brazil, ( 14 , 17 ) with 11% (n=2), and the United States ( 1 ) (n=1), Sweden ( 11 ) (n=1), Turkey ( 2 ) (n=1), Greece ( 13 ) (n=1), Israel ( 15 ) (n=1), Belgium ( 16 ) (n=1), Germany ( 8 ) (n=1), Korea ( 6 ) (n=1), and Switzerland ( 9 ) (n=1), accounting altogether for 50% (n=9) of articles. Based on this evidence, there is no effect of geographies or economies on patients affected by AARONJ.…”

“…The most affected region was the mandible (95% of cases), and the left side was involved in 69% of individuals (n=13), ( 1 , 3 , 4 , 8 , 10 – 14 , 16 – 18 ) the right side in 21% (n=4), ( 2 , 5 , 15 , 19 ) and both sides simultaneously in 5%. ( 6 ) The left maxillary sinus was reported in 5% of cases. ( 9 ) This predilection for the mandibular region is explained by it being formed by compacted bone, which means less blood supply within its structure when compared with the maxilla, ( 4 , 7 , 8 ) and it also has portions of thinner mucosa lining bony protuberances, such as the mylohyoid line.…”