Medication related osteonecrosis of the jaws associated with targeted therapy as monotherapy and in combination with anti-resorptives. a report of seven cases from the copenhagen ONJ cohort

Publication date: Available online 6 November 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Hoda Abel Mahedi Mohamed, Charlotte Emilie Nor Nielsen, Morten Schiodt
ObjectiveTo report cases of medication related osteonecrosis of the jaws (MRONJ) associated with Targeted Therapy (TT) with and without concomitant anti-resorptive treatment, among The Copenhagen ONJ Cohort, which includes all consecutive cases of MRONJ seen in Copenhagen.Study designWe retrospectively studied the medication of 204 consecutive MRONJ patients, seen between January 2010 and May 2016, in order to identify those associated with TT.ResultsWe detected seven cases of MRONJ associated with TT (3.4 %). Four patients received TT only, whereas three 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 stage 1 and 2, and mean pain from the jaw was VAS 4.0.ConclusionHealth care providers should be aware of the possibility of MRONJ related to the TT agents sunitinib, everolimus and dasatinib and to patients with uncommon cancer types, including renal cell carcinoma, non-small-cell lung cancer, glioblastoma and leukemia, where MRONJ may also occur.



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