Worsening of osteonecrosis of the jaw during treatment with sunitinib in a patient with metastatic renal cell carcinoma

Osteonecrosis of jaw beyond antiresorptive (bone-targeted) agents: new horizons in oncology

“…[55][56][57][58][59][60][61][62] In a limited cohort, Christodolou et al observed 5 cases of ONJ among 116 patients who had been receiving BPs from 2007 to 2008, of which 4 had received bevacizumab or sunitinib, [10] thus suggesting an increased risk of ONJ, which is derived from an association of BPs and innovative agents.…”

“…[89] Besides initial reports of patients also treated with BPs, [10,55,56,58,62,90] sunitinib appeared as the only agent administered in some RCC patients suffering of ONJ [59][60][61] Furthermore, sunitinib was associated to BPs in numerous ONJ cases in RCC population, [67] with an incidence higher than expected when a denominator was reported. [13,57,69] However, Smidt-Hansen reported the possibility of decreasing the ONJ risk after adopting preventive measures (as well as recommended in general BP-treated population).…”

“…Further data are needed about the possibility that ONJ related to antiangiogenic agents show predominantly a clinical history different from that -already heterogeneous -of BRONJ: some papers reported about consecutive episodes of painful jaw infections, [56] with self-limiting history after antibiotic treatment and drug suspension [73]and without bone exposure or with limited exposure in time and in largeness. Imaging studies (particularly by computed tomography (CT) or bone scan scintigraphy) in case of symptomatic oral health discomfort in cancer patients receiving antiangiogenic and targeted therapies should be of great importance, as a large part of ONJ cases might escape the classical definition (requiring 8-week lasting bone exposure).…”

Bevacizumab and osteonecrosis of the jaw: incidence and association with bisphosphonate therapy in three large prospective trials in advanced breast cancer

“…An analysis of ONJ among patients receiving bevacizumab, docetaxel, thalidomide, and prednisone for metastatic endocrine-resistant prostate cancer suggested an 18% incidence of ONJ [9]. Individual cases of ONJ have been reported in the literature among zoledronate-exposed patients treated with sunitinib for renal cell carcinoma [22,23].…”

Osteochemonecrosis: An Overview

“…VEGF inhibitors work somewhat more directly to inhibit the osteoclasts through their action on monocytes which then are in the osteoclast developmental feedback loop. Further reading on these medications will be left to the reader for exploration [30][31][32][33][34][35][36][37][38][39][40].…”