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Medication related osteonecrosis of the jaws associated with targeted therapy as monotherapy and in combination with antiresorptives. A report of 7 cases from the Copenhagen Cohort

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OBJECTIVE: The aim of this study was to report cases of medication-related osteonecrosis of the jaws (MRONJ) associated with targeted therapy (TT) with or without concomitant antiresorptive treatment, among the Copenhagen ONJ cohort, which includes all consecutive cases of MRONJ seen in Copenhagen.

STUDY DESIGN: We retrospectively studied the treatment of 204 consecutive patients with MRONJ, seen between January 2010 and May 2016, to identify those associated with TT.

RESULTS: We detected 7 cases of MRONJ associated with TT (3.4%). Four patients received TT only, whereas 3 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 stages 1 and 2, and mean score on the visual analogue scale for pain in the jaw was 4.0.

CONCLUSIONS: Health care providers should be aware of the possibility of MRONJ associated with the TT agents sunitinib, everolimus, and dasatinib and uncommon cancer types, including renal cell carcinoma, non-small-cell lung cancer, glioblastoma, and leukemia, where MRONJ may also occur.

Original languageEnglish
JournalOral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Issue number2
Pages (from-to)157-163
Number of pages7
Publication statusPublished - Feb 2018

    Research areas

  • Aged, Aged, 80 and over, Antineoplastic Agents/adverse effects, Bisphosphonate-Associated Osteonecrosis of the Jaw/epidemiology, Bone Density Conservation Agents/adverse effects, Dasatinib/adverse effects, Denmark/epidemiology, Everolimus/adverse effects, Female, Humans, Indoles/adverse effects, Male, Middle Aged, Neoplasms/drug therapy, Pyrroles/adverse effects, Retrospective Studies, Sunitinib

ID: 56437901