Use of denosumab in parathyroid carcinoma with refractory hypercalcemia

Tong, Chin Voon; Hussein, Zanariah; Noor, Nurain Mohd; Mohamad, M.; Ng, William

doi:10.1093/qjmed/hcu166

Cited by 27 publications

(12 citation statements)

References 5 publications

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“…The present case, together with recent reports, clearly demonstrates the efficacy of denosumab for refractory hypercalcemia due to parathyroid carcinoma (10)(11)(12)(13)(14). The initial treatment with denosumab in the present case was based on the standard protocol for bone metastases in patients with advanced cancer, in which loading doses of denosumab are 120 mg every 4 weeks (7-9).…”

Section: Discussionsupporting

confidence: 59%

“…It has been used to treat bone metastases in patients with advanced cancer or multiple myeloma (7)(8)(9) but is rarely used for PTH-induced hypercalcemia. The successful treatment of patients with metastatic parathyroid carcinoma with refractory hypercalcemia with denosumab was recently described in several reports (10)(11)(12)(13)(14). We provide an additional case of parathyroid carcinoma successfully treated with denosumab with injection intervals extended to as long as 3 months.…”

Section: Introductionmentioning

confidence: 74%

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Denosumab for the Treatment of Refractory Hypercalcemia in Metastatic Parathyroid Carcinoma

Itoshima

Yuno

Kato

et al. 2015

AACE Clinical Case Reports

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Objective: Parathyroid carcinoma is a rare malignant neoplasm. Hypercalcemia due to parathyroid carcinoma is often resistant to medical management in the advanced stage. Here we report the usefulness of denosumab as an option for managing refractory hypercalcemia in the setting of parathyroid carcinoma.Methods: A 39-year-old Japanese female with metastatic parathyroid carcinoma was referred to our hospital due to frequent episodes of hypercalcemia. Upon admission, her respective serum calcium (Ca) and intact parathyroid hormone (PTH) levels were 13.3 mg/dL (reference range, 8.5-10.2 mg/dL) and 1,920 pg/mL (reference range, 10-65 pg/mL). Although her hypercalcemia initially responded to strengthened standard therapy, it became unmanageable as her disease progressed. A single denosumab injection dramatically decreased her hypercalcemia from 15.1 to 10.1 mg/dL within 10 days. Her Ca levels remained in the reference range for more than 1 month. Her hypercalcemia could be controlled by denosumab injected at a frequency lower than that used for the bone metastasis of malignant tumors.Results: Although her serum PTH level increased to 4,130 pg/mL, her condition has remained good for the last 14 months.Conclusions: Denosumab is a humanized monoclonal antibody that inhibits the receptor activator of nuclear factor-kB ligand (RANKL) and is a potentially important palliative treatment for refractory hypercalcemia due to parathyroid carcinoma. (AACE Clinical Case Rep. 2015;2:e141-e144) Abbreviations: Ca = calcium; PTH = parathyroid hormone; RANK = receptor activator of nuclear factor-kB; RANKL = receptor activator of nuclear factor-kB ligand; TRACP-5b = tartrate-resistant acid phosphatase 5b

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Section: Discussionsupporting

confidence: 59%

Section: Introductionmentioning

confidence: 74%

Denosumab for the Treatment of Refractory Hypercalcemia in Metastatic Parathyroid Carcinoma

Itoshima

Yuno

Kato

et al. 2015

AACE Clinical Case Reports

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“…Management of refractory hypercalcemia due to metastatic PC has included bisphosphonates and calcimimetic agents, however denosumab, a human monoclonal antibody against RANKL which inhibits osteoclast survival, has also been suggested as a safe alternative [41][42][43][44]. Unfortunately, as with most medical therapies, treatment effect weakens over time and each of these options are unlikely to provide long-term relief.…”

Section: Adjuvant Treatmentmentioning

confidence: 99%

Current and Future Treatments for Parathyroid Carcinoma

Long

Sippel

2018

Int. J. Endo. Oncol.

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Parathyroid carcinoma (PC) is a rare disease and presents clinical challenges in diagnosis, management and adjuvant treatment. Rarely diagnosed preoperatively, PC is often discovered in the treatment of primary hyperparathyroidism. PC is predominantly treated surgically with minimal additional treatments available. Given the rarity of the disease, current and future efforts, as discussed in this article, are focused on increasing preoperative diagnosis, recognizing genetic patterns and pathologic markers and delineating nonsurgical options for patients with advanced disease.

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“…It is a potent inhibitor of bone resorption. Case reports show that denosumab effectively controlled refractory hypercalcemia in patients with parathyroid cancer previously treated with surgery, bisphosphonates, cinacalcet, and dacarbazine [99][100][101]. Stabilization of serum calcium levels may last for a few weeks or as long, as two years.…”

Section: Medical Managementmentioning

confidence: 99%

Current Understanding and Management of Parathyroid Carcinoma

Arrangoiz¹

2017

JCTR

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Parathyroid adenomas are a very common endocrine entity, whereas parathyroid carcinomas (PC) are extremely rare. With an estimated incidence of 0.015 per 100,000 population and an estimated prevalence of 0.005% in the United States, parathyroid cancer is one of the rarest of all human malignancies. PC is an extremely rare cause of primary hyperparathyroidism (PHPT). Men and women are equally affected, usually in the fourth or fifth decade of life. The exact etiology has not been identified, but mutations in the CDC73 gene appear to have a critical role in its pathogenesis. The morbidity and mortality of PC is secondary to the hypercalcemia resulting from tumor overproduction of PTH. The primary management objectives are complete removal of the cancer and prevention of recurrences. This review will talk about the epidemiology, etiology, clinical manifestations, and management of PC.

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Use of denosumab in parathyroid carcinoma with refractory hypercalcemia

Cited by 27 publications

References 5 publications

Denosumab for the Treatment of Refractory Hypercalcemia in Metastatic Parathyroid Carcinoma

Denosumab for the Treatment of Refractory Hypercalcemia in Metastatic Parathyroid Carcinoma

Current and Future Treatments for Parathyroid Carcinoma

Current Understanding and Management of Parathyroid Carcinoma

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