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Guida A, Perri F, Ionna F, Ascierto PA, Grimaldi AM. New-generation anticancer drugs and medication-related osteonecrosis of the jaw (MRONJ): Late onset 3 years after ipilimumab endovenous administration with a possible role of target therapy. Clin Case Rep 2021; 9:61-66. [PMID: 33489133 PMCID: PMC7813008 DOI: 10.1002/ccr3.3418] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 09/28/2020] [Accepted: 10/04/2020] [Indexed: 12/24/2022] Open
Abstract
Association of immunotherapy and/or chemotherapy and/or targeted therapy, in sequence or as single therapies, may induce osteonecrosis of the jaw. Multidisciplinary team management of these patients should be provided.
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Affiliation(s)
- Agostino Guida
- Maxillo‐facial and ENT Surgery UnitINT – IRCCS “Fondazione G. Pascale”NaplesItaly
| | - Francesco Perri
- Head & Neck/Thyroid Medical Oncology UnitINT – IRCCS “Fondazione G. Pascale”NaplesItaly
| | - Franco Ionna
- Maxillo‐facial and ENT Surgery UnitINT – IRCCS “Fondazione G. Pascale”NaplesItaly
| | - Paolo A. Ascierto
- Melanoma, Oncological Immunotherapy and Innovative Therapies DepartmentINT – IRCCS “Fondazione G. Pascale”NaplesItaly
| | - Antonio M. Grimaldi
- Melanoma, Oncological Immunotherapy and Innovative Therapies DepartmentINT – IRCCS “Fondazione G. Pascale”NaplesItaly
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Nicolatou‐Galitis O, Papadopoulou E, Vardas E, Kouri M, Galiti D, Galitis E, Alexiou K, Tsiklakis K, Ardavanis A, Razis E, Athanasiadis I, Droufakou S, Psyrri A, Karamouzis MV, Linardou H, Daliani D, Tzanninis D, Sachanas S, Laschos K, Kyrtsonis M, Antoniou F, Laskarakis A, Giassas S, Nikolaidi A, Rigakos G, Ntokou A, Migliorati CA, Ripamonti CI. Alveolar bone histological necrosis observed prior to extractions in patients, who received bone‐targeting agents. Oral Dis 2020; 26:955-966. [DOI: 10.1111/odi.13294] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Revised: 12/26/2019] [Accepted: 01/28/2020] [Indexed: 12/20/2022]
Affiliation(s)
- Ourania Nicolatou‐Galitis
- Clinic of Hospital Dentistry Densstal School National & Kapodistrian University of Athens Athens Greece
| | - Erofili Papadopoulou
- Clinic of Hospital Dentistry Densstal School National & Kapodistrian University of Athens Athens Greece
| | - Emmanouil Vardas
- Clinic of Hospital Dentistry Densstal School National & Kapodistrian University of Athens Athens Greece
| | - Maria Kouri
- Clinic of Hospital Dentistry Densstal School National & Kapodistrian University of Athens Athens Greece
| | - Dimitra Galiti
- Clinic of Oral Diagnosis & Radiology Dental School National & Kapodistrian University of Athens Athens Greece
| | - Evangelos Galitis
- Clinic of Oral and Maxillofacial Surgery Dental School National & Kapodistrian University of Athens Athens Greece
| | - Konstantina‐Eleni Alexiou
- Clinic of Oral Diagnosis & Radiology Dental School National & Kapodistrian University of Athens Athens Greece
| | - Kostas Tsiklakis
- Clinic of Oral Diagnosis & Radiology Dental School National & Kapodistrian University of Athens Athens Greece
| | | | - Evangelia Razis
- Third Medical Oncology Department Hygeia Hospital Athens Greece
| | | | | | - Amanda Psyrri
- Attikon Hospital National and Kapodistrian University of Athens Athens Greece
| | - Michalis V. Karamouzis
- Department of Biological Chemistry and First Department of Internal Medicine Laikon Hospital, Medical School National and Kapodistrian University of Athens Athens Greece
| | | | - Danai Daliani
- First Medical Oncology Department Euroclinic of Athens Athens Greece
| | | | - Sotirios Sachanas
- Department of Hematology Athens Medical Center Psychikon Branch Athens Greece
| | - Konstantinos Laschos
- 2nd Oncology Department General and Oncologic Hospital “Agii Anargyri” Athens Greece
| | | | - Fotini Antoniou
- Department of Oncology Unit Elena Venizelou Maternity Hospital Athens Greece
| | | | - Styllianos Giassas
- 2nd Oncology Clinic IASO Maternity Hospital and 3rd Oncology Clinic Metropolitan General Hospital Athens Greece
| | | | - George Rigakos
- Third Medical Oncology Department Hygeia Hospital Athens Greece
| | - Anna Ntokou
- Oncology Department Saint Savvas Hospital Athens Greece
| | - Cesar A. Migliorati
- Department of Diagnostic Sciences and Oral Medicine University of Florida Health Science Center College of Dentistry Gainesville FL USA
| | - Carla I. Ripamonti
- Supportive Care Unit Department of Medical Oncology and Haematology Fondazione IRRCS Istituto Nazionale dei Tumori Milano Italy
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Nicolatou-Galitis O, Kouri M, Papadopoulou E, Vardas E, Galiti D, Epstein JB, Elad S, Campisi G, Tsoukalas N, Bektas-Kayhan K, Tan W, Body JJ, Migliorati C, Lalla RV. Osteonecrosis of the jaw related to non-antiresorptive medications: a systematic review. Support Care Cancer 2018; 27:383-394. [PMID: 30353228 DOI: 10.1007/s00520-018-4501-x] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 10/03/2018] [Indexed: 12/19/2022]
Abstract
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.
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Affiliation(s)
- Ourania Nicolatou-Galitis
- Dental School, National and Kapodistrian University of Athens, Bouboulinas 41, N. Psyhico, 154 51, Athens, Greece.
| | - Maria Kouri
- Dental School, National and Kapodistrian University of Athens, Bouboulinas 41, N. Psyhico, 154 51, Athens, Greece
| | - Erofili Papadopoulou
- Dental School, National and Kapodistrian University of Athens, Bouboulinas 41, N. Psyhico, 154 51, Athens, Greece
| | - Emmanouil Vardas
- Dental School, National and Kapodistrian University of Athens, Bouboulinas 41, N. Psyhico, 154 51, Athens, Greece
| | - Dimitra Galiti
- Dental School, National and Kapodistrian University of Athens, Bouboulinas 41, N. Psyhico, 154 51, Athens, Greece
| | - Joel B Epstein
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Health System, Los Angeles CA and City of Hope National Medical Center, Duarte, CA, USA
| | - Sharon Elad
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA
| | - Giuseppina Campisi
- Sector of Oral Medicine "V. Margiotta", Department Di.Chir.On.S, University of Palermo, Palermo, Italy
| | - Nikolaos Tsoukalas
- Consultant Medical Oncologist, Oncology Department, Veterans Hospital (NIMTS), Athens, Greece
| | - Kivanc Bektas-Kayhan
- Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Istanbul University, Istanbul, Turkey
| | - Winston Tan
- Hematology/Oncology, Mayo Clinic Florida, Jacksonville, FL, USA
| | | | - Cesar Migliorati
- Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, Gainesville, FL, USA
| | - Rajesh V Lalla
- Section of Oral Medicine, University of Connecticut School of Dental Medicine, Farmington, CT, USA
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Medication-related osteonecrosis of the jaw: definition and best practice for prevention, diagnosis, and treatment. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 127:117-135. [PMID: 30393090 DOI: 10.1016/j.oooo.2018.09.008] [Citation(s) in RCA: 150] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 08/16/2018] [Accepted: 09/27/2018] [Indexed: 12/20/2022]
Abstract
Skeletal complications caused by osteoporosis or bone metastases are associated with considerable pain, increased mortality, and reduced quality of life. Furthermore, such events place a burden on health care resources. Agents that prevent bone resorption, such as bisphosphonates or denosumab, can reduce the risk of skeletal-related events and are widely used in patients with osteoporosis or bone metastases of cancer. Medication-related osteonecrosis of the jaw (MRONJ) is a rare, but potentially serious, adverse event associated with high cumulative doses of bisphosphonates or denosumab. However, MRONJ can be treated, and the likelihood of the development of this condition can be reduced through prophylactic dental care and the maintenance of good oral hygiene. Dentists, as part of a multiprofessional team, have a critical role in preventing MRONJ. This review describes the incidence and pathophysiology of MRONJ and provides guidance for dental practitioners with regard to the screening, prophylactic treatment, diagnosis, and management of patients with this condition.
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Owosho AA, Liang STY, Sax AZ, Wu K, Yom SK, Huryn JM, Estilo CL. Medication-related osteonecrosis of the jaw: An update on the memorial sloan kettering cancer center experience and the role of premedication dental evaluation in prevention. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 125:440-445. [PMID: 29580668 DOI: 10.1016/j.oooo.2018.02.003] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2017] [Revised: 01/11/2018] [Accepted: 02/05/2018] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the relationship between type of antiresorptive medication and medication-related osteonecrosis of the jaw (MRONJ) onset and the role of premedication dental evaluation (PMDE) in the prevention of MRONJ. STUDY DESIGN Our database of patients with MRONJ was reviewed. The Kruskal-Wallis test was used to analyze the onset dose of the 3 frequent medication types associated with MRONJ. To evaluate the role of PMDE in the prevention of MRONJ, all patients on antiresorptive and/or antiangiogenic medications seen in the Dental Service of Memorial Sloan Kettering Cancer Center during a 10-year period were subclassified into 2 groups. Group I comprised patients seen for PMDE before the commencement of A/A and group II patients seen after prior exposure to antiresorptive and/or antiangiogenic medications. Fischer's exact test was used to compare the incidence of MRONJ in both groups. RESULTS Patients on denosumab developed MRONJ earlier compared with zoledronate and pamidronate (P = .003). Group I had a significantly reduced incidence of MRONJ (0.9%) compared with group II (10.5%) (P < .0001). Dentoalveolar trauma as a precipitating factor between groups I and II was not statistically significant. CONCLUSIONS Denosumab was associated with an earlier occurrence of MRONJ compared with zoledronate and pamidronate. The role of PMDE may be an effective preventive strategy in reducing the incidence of MRONJ.
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Affiliation(s)
- Adepitan A Owosho
- College of Dental Medicine, University of New England, Portland, Maine, USA; Dental Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - See Toh Yoong Liang
- National Dental Centre Singapore, Second Hospital Avenue, Singapore; Dental Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Adi Z Sax
- Dental Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Kant Wu
- Dental Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - SaeHee K Yom
- Dental Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Joseph M Huryn
- Dental Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Cherry L Estilo
- Dental Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
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McGowan K, McGowan T, Ivanovski S. Risk factors for medication-related osteonecrosis of the jaws: A systematic review. Oral Dis 2017; 24:527-536. [DOI: 10.1111/odi.12708] [Citation(s) in RCA: 78] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 06/15/2017] [Accepted: 06/21/2017] [Indexed: 02/05/2023]
Affiliation(s)
- K McGowan
- School of Dentistry & Oral Health; Griffith University; Southport QLD Australia
| | - T McGowan
- School of Dentistry & Oral Health; Griffith University; Southport QLD Australia
| | - S Ivanovski
- Menzies Health Institute Queensland; School of Dentistry & Oral Health; Griffith University; Southport QLD Australia
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