Osteonecrosis of the Jaw during Sorafenib Therapy for Hepatocellular Carcinoma

Garuti, Francesca; Camelli, V.; Spinardi, Luca; Bucci, Laura; Trevisani, Franco

doi:10.5301/tj.5000504

Cited by 28 publications

(24 citation statements)

References 5 publications

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“…The mean age of patients with AARONJ was 59.7 years, and the median, 60 years, with minimum age of 47 years ( 3 ) and maximum age of 79 years. ( 4 ) In respect to sex, 11 patients were male (58%) ( 2 – 4 , 10 , 14 – 17 , 19 ) and 8 were female (42%); ( 1 , 5 , 6 , 8 , 9 , 12 , 13 , 16 , 18 ) different from what the AAOMS reported in 2014. ( 7 ) The race of patients was not described in the articles and, therefore, was excluded from the final result table.…”

Section: Discussionmentioning

confidence: 69%

“…In the selected articles, most were published in Italy, ( 3 – 6 , 10 , 12 , 18 , 19 ) i.e , 39% (n=7), followed by Brazil, ( 14 , 17 ) with 11% (n=2), and the United States ( 1 ) (n=1), Sweden ( 11 ) (n=1), Turkey ( 2 ) (n=1), Greece ( 13 ) (n=1), Israel ( 15 ) (n=1), Belgium ( 16 ) (n=1), Germany ( 8 ) (n=1), Korea ( 6 ) (n=1), and Switzerland ( 9 ) (n=1), accounting altogether for 50% (n=9) of articles. Based on this evidence, there is no effect of geographies or economies on patients affected by AARONJ.…”

Section: Discussionmentioning

confidence: 99%

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Risk profile for antiangiogenic agent-related osteonecrosis of the jaws

Caminha¹,

Chicrala²,

Júnior³

et al. 2019

Einstein (São Paulo)

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To establish the profile of patients who developed antiangiogenic agent-related osteonecrosis of the jaws, and identify the treatments currently used in dental management. We searched the PubMed ® /Medline ® and Scopus databases using the words “osteonecrosis AND antiangiogenic therapy”, with the following inclusion criteria: articles published in English, case reports, available online, and for an unlimited period. Of the 209 articles retrieved, 18 were selected, for a total of 19 case reports, since one article included two cases that met the inclusion criteria for this study. Medication-related osteonecrosis of the jaws is characterized by exposure of necrotic bone in the oral cavity that does not heal over a period of 8 weeks in patients with no previous history of radiation therapy. Antiangiogenic drugs are indicated in the treatment of certain tumors, since they stop the formation of new blood vessels, controlling tumor growth and the chance of metastasis. Dental prevention is essential in patients who will be put on antiangiogenic agents, to minimize the risk for osteonecrosis.

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Section: Discussionmentioning

confidence: 69%

Section: Discussionmentioning

confidence: 99%

Risk profile for antiangiogenic agent-related osteonecrosis of the jaws

Caminha¹,

Chicrala²,

Júnior³

et al. 2019

Einstein (São Paulo)

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“…However, shortly afterwards, dozens of new cases started to be published for patients solely treated with these medications (4,18,44). The last 5 years have also seen the publication of new cases of MRONJ associated with other antiangiogenics such as Dasatinib (49,50), Erlotinib (50), Imatinib (50,51), Axitinib (52), sorafenib (53) and cabozantinib (54). Therefore, these could be considered to be risk medications for MRONJ.…”

Section: A B Cmentioning

confidence: 99%

“…The ONJ cases associated with antiangiogenic drugs may appear spontaneously or following surgery and, as is the case with antiresorptives, they are also more common in the mandible. The time between the start of treatment and the appearance of ONJ is extremely variable, ranging from a few weeks to 15 months (45,(49)(50)(51)(52)(53)(54)(55). Table 3 gives a list of the antiangiogenic drugs that have been related to cases of MRONJ, together with their brand name and route of administration.…”

Section: A B Cmentioning

confidence: 99%

Review and update on drugs related to the development of osteonecrosis of the jaw

Eguia¹,

Bagán-Debón²,

Cardona³

2020

Med Oral

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Background: Medication-related osteonecrosis of the jaw (MRONJ) is a rare, but serious adverse effect of certain drugs, of which bisphosphonates are the most widely known. This pathology is also associated with other medications such as the biologic antiresorptive agent, denosumab and some antiangiogenics such as sunitinib, bevacizumab or aflibercept. Very recently, new medications have also been associated with osteonecrosis of the jaw (ONJ). The objectives were to update the list of medications associated with ONJ, to analyze the fundamental aspects of this list and to describe the level of evidence available. Material and Methods: A narrative bibliographic review was made, using the PubMed-MedLine, DOAJ and SCI-ELO databases. Additional information was obtained through the online Medication Information Centre of the Spanish Agency of Medicines and Medical Devices (AEMPS-CIMA), the websites of the US Food & Drugs Administration (Drugs@FDA) and the European Medicines Agency (EMA). Results: The latest drugs identified as potential facilitators of this pathology include a number of anti-VEGF based antiangiogenic drugs and anti-TKI and different types of immunomodulators. Neither the level of evidence in this association nor the risk are equal for all these drugs. On the other hand, over the coming years, new drugs will be marketed with similar action mechanisms to those that are recognized as having this adverse effect. Conclusions: No effective therapy is currently known for the treatment of ONJ. Therefore, in order to prevent new cases of MRONJ, it is essential for all oral healthcare professionals to be fully up-to-date with the etiopathogenic aspects of this pathology and to be aware of those drugs considered to be a risk.

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“…Several case reports have demonstrated an association between sunitinib alone and ONJ, after one-year treatment1011. The first case of ONJ in a cirrhotic patient with hepatocellular carcinoma treated with sorafenib has been described12. Periodontal and dental infections, and dental extractions are the main risk factors13.…”

Section: Tyrosine Kinase Inhibitors (Tkis)mentioning

confidence: 99%

Osteonecrosis of the jaw in the era of targeted therapy and immunotherapy in oncology

Nifosì

Zuccarello

Lorenzo

et al. 2019

J Korean Assoc Oral Maxillofac Surg

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Osteonecrosis of the jaw (ONJ) is a well-known pathological condition in oncology derived from the use of bisphosphonates (BPs) and denosumab. Many molecular and immunological targets have been introduced for daily use in cancer treatment in recent years; consequently, new cases of ONJ have been reported in association with these drugs, especially if administered with BPs and denosumab. When the drugs are administered alone, ONJ is rarely seen. The objective of our study was to analyze the recent literature relative to the association of ONJ with these new drugs highlighting the pathogenic, clinical and therapeutic aspects. The close collaboration between maxillofacial surgeon, oncologist, dentist, and dental hygienist remains the most important aspect for the prevention, prompt recognition, and treatment of this pathology.

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Osteonecrosis of the Jaw during Sorafenib Therapy for Hepatocellular Carcinoma

Abstract: To our knowledge, this is the first description of osteonecrosis of the jaw detected in a cirrhotic patient on sorafenib therapy not combined with bisphosphonates.

Cited by 28 publications

References 5 publications

Risk profile for antiangiogenic agent-related osteonecrosis of the jaws

Risk profile for antiangiogenic agent-related osteonecrosis of the jaws

Review and update on drugs related to the development of osteonecrosis of the jaw

Osteonecrosis of the jaw in the era of targeted therapy and immunotherapy in oncology

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