Osteonecrosis of the Jaw Related to Bevacizumab

Estilo, Cherry L.; Fornier, Monica; Farooki, Azeez; Carlson, Diane L.; Bohle, George C.; Huryn, Joseph M.

doi:10.1200/jco.2007.15.5424

Cited by 208 publications

(137 citation statements)

References 10 publications

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“…The first two reports regarding the association of ONJ with bevacizumab both derived from the Memorial Sloan Kettering Cancer Center (MSKCC) in New York. Estilo et al [11] published a report in the Journal of Clinical Oncology regarding two cases of osteonecrosis of the jawbone, in one patient with breast cancer and in one patient with glioblastoma, both of whom had been treated with bevacizumab with no history of BP therapy. At the 2008 annual ASCO meeting, McArthur et al [51] presented an abstract with cases of ONJ in patients treated at MSKCC only with BPs (72 out of 6561, 1.1%) or BPs and bevacizumab (8 out of 409, 2.0%).…”

Section: Association Of Antingiogenic Drugs and Antiresorptive Agentsmentioning

confidence: 99%

“…[17] In succeeding years, the term BRONJ entered largely in use in medical literature, also when the first cases of ONJ after treatment including antiangiogenic agents and denosumab began to be reported. [18,19] In the same years, clinical practice and literature [20,21] showed increasing evidence of symptomatic cases of BP-related jawbone alterations without frank bone exposure, therefore, questioning the ONJ definition.…”

Section: Definition Of Onjmentioning

confidence: 99%

“…The first case report associating bevacizumab with the onset of ONJ was published in 2008 [11]; subsequently, it was retrospectively analyzed for the data of safety on the use of bevacizumab in improving the clinical outcome of patients with breast cancer (ATHENA, AVADO, and RIBBON-1) [12] demonstrating that the concomitant use of bevacizumab plus intravenous BPs significantly increased the risk of ONJ compared with the use of bevacizumab or BP alone. The same mechanism that underlies the hypothetical pathogenesis of ONJ with the use of bevacizumab may be shifted to the administration of TKIs in particular with sunitinib in metastatic renal carcinoma and gastro intestinal stromal tumor (GIST).…”

Section: Introductionmentioning

confidence: 99%

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Osteonecrosis of jaw beyond antiresorptive (bone-targeted) agents: new horizons in oncology

Fusco

Santini

Armento

et al. 2016

Expert Opinion on Drug Safety

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Introduction: Osteonecrosis of the jaw (ONJ) is a clinically important, potentially painful and debilitating condition, which can affect the quality of life of cancer patients. Since 2003, ONJ appeared as a Bisphosphonate(BP)-related class effect, and the term Bisphosphonate-Related Osteonecrosis of the Jaw (BRONJ) was widespread. Areas Covered: Under discussion in this review is the fact that ONJ cases have been reported after treatment including antiangiogenic agents and other “targeted therapy”, with and without BPs. Consequently, the comprehensive term Medication-Related Osteonecrosis of the Jaw (MRONJ) has been introduced. The clinical aspects and the prognosis of ONJ associated with these new drugs are still less reported, but basing on their pharmacodynamics, they could be different from the well-known BRONJ. Accordingly, recommendations largely in use for BRONJ should be extended to these new forms, but critically applied and with respect to the individual risk assessment. Expert Opinion: There is a high risk of underdiagnoses for ONJ due to a lack of awareness, and too much restrictive or incomplete diagnostic criteria; at the same time, with regard to ONJ associated to the new non –antiresorptive agents, described here, we observe the strong need to improve the defining of any distinguished feature in their diagnosis, prevention and therapy

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Section: Association Of Antingiogenic Drugs and Antiresorptive Agentsmentioning

confidence: 99%

Section: Definition Of Onjmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Osteonecrosis of jaw beyond antiresorptive (bone-targeted) agents: new horizons in oncology

Fusco

Santini

Armento

et al. 2016

Expert Opinion on Drug Safety

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“…This patient setting is particularly susceptible to ONJ due to the concomitant use of antiangiogenic drugs that block vascular endothelial growth factor (VEGF). In recent years, some cases of ONJ have been reported during treatment with bevacizumab 14,15 and sunitinib. 16 whereby it is possible that the potent antiangiogenic activity of VEGF-targeting agents may inhibit bone remodeling and promote ONJ development.…”

Section: Stagementioning

confidence: 99%

Multifocal brown tumor of the maxilla and mandible in primary hyperparathyroidism – diagnostic challenges and literature review

Gogolewski¹,

Jędrusik-Pawłowska²,

Drozdzowska³

2017

Dent. Med. Probl.

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Osteonecrosis of the jaw (ONJ) is a rare treatment-related side effect of anti-resorptive drugs whose risk is increased by concomitant local and systemic factors. The number of cases of medication-related ONJ is constantly increasing as a result of the rising tide of molecular-targeted and immunological drugs used in cancer treatment. Denosumab-related ONJ presents peculiar pathophysiological, histopathological, clinical, and therapeutic features compared to that induced by bisphosphonates-related ONJ.This study aimed to compare ONJ induced by denosumab to that caused by bisphosphonates. We have reviewed the literature of the last 5 years on denosumab-related ONJ, focusing on reviews and metaanalyses.The physiopathology of ONJ is unclear. Denosumab acts on receptor activator of nuclear factor kappa-B ligand (RANKL) to inhibit the formation and activity of osteoclasts. The reduction of bone turnover seems to play an important role. Dentists and oral surgeons in the coming years will see an increasing number of patients who are receiving treatment potentially toxic to bone, but also require good dental care. Early recognition of ONJ is essential in the patient's treatment with denosumab, therefore a close collaboration between the dentist and oncologist is fundamental.

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“…VEGF inhibitors work somewhat more directly to inhibit the osteoclasts through their action on monocytes which then are in the osteoclast developmental feedback loop. Further reading on these medications will be left to the reader for exploration [30][31][32][33][34][35][36][37][38][39][40].…”

Section: History and Medication Review Of Osteochemonecrosismentioning

confidence: 99%