Osteonecrosis of the jaw (ONJ) among intravenous (IV) bisphosphonate- and/or bevacizumab-treated patients (pts) at Memorial Sloan-Kettering Cancer Center (MSKCC)
2008; Lippincott Williams & Wilkins; Volume: 26; Issue: 15_suppl Linguagem: Inglês
10.1200/jco.2008.26.15_suppl.9588
ISSN1527-7755
AutoresHeather L. McArthur, Cherry L. Estilo, Joseph M. Huryn, T. Williams, Monica Fornier, TA Traina, JESSICA M. HOWARD, C. Hudis, Maura N. Dickler,
Tópico(s)Bone Tumor Diagnosis and Treatments
Resumo9588 Background: ONJ is diagnosed with increasing frequency among IV bisphosponate (IVBP)-treated cancer pts, in the range of 1–10 per 100 treated pts depending on duration of therapy (Khosla 2007). The etiology and specific incidence of this phenomenon is uncertain. However, ONJ pathogenesis may reflect defects in bone remodeling or wound healing (Ruggiero 2006). Bevacizumab (B) is an anti-vascular endothelial growth factor (VEGF) antibody that has demonstrated significant benefits alone or in combination with chemotherapy for several cancers. As an anti-angiogenesis molecule, B may exacerbate IVBP-induced ONJ. We report the results of a retrospective, single institution study of incident ONJ cases among IVBP- and/or B-treated pts. Methods: Institutional databases were surveyed to identify the 8,681 pts treated with IVBPs (pamidronate and/or zoledronic acid) and/or B between January 1, 2001 and October 24, 2007 at MSKCC. Incident ONJ diagnoses were identified from the MSKCC dental database and described by treatment cohort. Results: Of the 80 IVBP- and/or B- treated patients diagnosed with ONJ within the study period, the median age at ONJ diagnosis was 64.2y (range 25.9–91.6y) and 47 (59%) were female. 38 (47.5%) had breast cancer, 20 (25%) multiple myeloma, 14 (17.5%) prostate cancer, 4 (5%) lung cancer, and 4 (5%) another primary. The incidence of ONJ by treatment cohort was 72 (1.1%) of the 6,561 patients treated with IV pamidronate and/or zoledronic acid alone; 0 (0%) of the 1,711 pts treated with B alone; and 8 (2.0%) of the 409 patients treated with the combination of B and IV pamidronate and/or zoledronic acid. Conclusions: There is a modest risk of ONJ with IVBP administration which may be compounded by B administration. However, B administration alone does not appear to be associated with significant ONJ risk. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Expert Testimony Other Remuneration Genentech, Novartis, Abraxis, Roche Genentech, Amgen, GlaxoSmithKline, Novartis, Abraxis, Roche Genentech, Novartis, Abraxis, Roche
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