TY - JOUR
T1 - Osteonecrosis of the jaw related to non-antiresorptive medications
T2 - a systematic review
AU - for the MASCC Bone Study Group
AU - Nicolatou-Galitis, Ourania
AU - Kouri, Maria
AU - Papadopoulou, Erofili
AU - Vardas, Emmanouil
AU - Galiti, Dimitra
AU - Epstein, Joel B.
AU - Elad, Sharon
AU - Campisi, Giuseppina
AU - Tsoukalas, Nikolaos
AU - Bektas-Kayhan, Kivanc
AU - Tan, Winston
AU - Body, Jean Jacques
AU - Migliorati, Cesar
AU - Lalla, Rajesh V.
N1 - Publisher Copyright:
© 2018, Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2019/2/1
Y1 - 2019/2/1
N2 - Introduction: The reporting of osteonecrosis of the jaw (ONJ) related to anticancer agents without known antiresorptive properties (non-antiresorptives), such as antiangiogenics, tyrosine kinase inhibitors, mammalian target of rapamycin inhibitors, immune checkpoint inhibitors, and cytotoxic chemotherapy is increasing. Objective: To review characteristics of ONJ in cancer patients receiving non-antiresorptives. Methods: A systematic review of the literature between 2009 and 2017 was conducted by the Bone Study Group of MASCC/ISOO. Results: Of 6249 articles reviewed and from personal communication, 42 ONJ cases related to non-antiresorptives were identified. No gender predilection was noted. Median age was 60 years and ONJ stage 2 was most common, with predilection for posterior mandible. Exposed bone, pain, and infection were common at diagnosis. In comparison to bone targeting agents (BTAs), radiology, histology, and management were similar, with medication often discontinued. Delayed diagnosis (median 8 weeks) was noted. Important differences included earlier time to ONJ onset (median 20 weeks), absence of trigger event (40%), and greater likelihood of healing and shorter healing time (median 8 weeks) as compared to BTA-related ONJ. Gastrointestinal cancers predominated, followed by renal cell carcinomas compared to breast, followed by prostate cancers in BTA-related ONJ, reflecting different medications. Conclusions: Data about non-antiresorptive-related ONJ is sparse. This type of ONJ may have better prognosis compared to the BTA-related ONJ, suggested by greater likelihood of healing and shorter healing time. However, the delay in diagnosis highlights the need for more education. This is the first attempt to characterize ONJ associated with different non-antiresorptives, including BRAF and immune checkpoint inhibitors.
AB - Introduction: The reporting of osteonecrosis of the jaw (ONJ) related to anticancer agents without known antiresorptive properties (non-antiresorptives), such as antiangiogenics, tyrosine kinase inhibitors, mammalian target of rapamycin inhibitors, immune checkpoint inhibitors, and cytotoxic chemotherapy is increasing. Objective: To review characteristics of ONJ in cancer patients receiving non-antiresorptives. Methods: A systematic review of the literature between 2009 and 2017 was conducted by the Bone Study Group of MASCC/ISOO. Results: Of 6249 articles reviewed and from personal communication, 42 ONJ cases related to non-antiresorptives were identified. No gender predilection was noted. Median age was 60 years and ONJ stage 2 was most common, with predilection for posterior mandible. Exposed bone, pain, and infection were common at diagnosis. In comparison to bone targeting agents (BTAs), radiology, histology, and management were similar, with medication often discontinued. Delayed diagnosis (median 8 weeks) was noted. Important differences included earlier time to ONJ onset (median 20 weeks), absence of trigger event (40%), and greater likelihood of healing and shorter healing time (median 8 weeks) as compared to BTA-related ONJ. Gastrointestinal cancers predominated, followed by renal cell carcinomas compared to breast, followed by prostate cancers in BTA-related ONJ, reflecting different medications. Conclusions: Data about non-antiresorptive-related ONJ is sparse. This type of ONJ may have better prognosis compared to the BTA-related ONJ, suggested by greater likelihood of healing and shorter healing time. However, the delay in diagnosis highlights the need for more education. This is the first attempt to characterize ONJ associated with different non-antiresorptives, including BRAF and immune checkpoint inhibitors.
KW - BRAF inhibitors
KW - Bone resorption
KW - Cytotoxic chemotherapy
KW - Immune checkpoint inhibitors
KW - Inhibitors of angiogenesis
KW - Osteonecrosis of the jaw
KW - Tyrosine kinase inhibitors
KW - mTOR inhibitors
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U2 - 10.1007/s00520-018-4501-x
DO - 10.1007/s00520-018-4501-x
M3 - Review article
C2 - 30353228
AN - SCOPUS:85055697161
SN - 0941-4355
VL - 27
SP - 383
EP - 394
JO - Supportive Care in Cancer
JF - Supportive Care in Cancer
IS - 2
ER -