Osteonecrosis of the jaw related to non-antiresorptive medications: a systematic review.

Bibliographic Details
Title: Osteonecrosis of the jaw related to non-antiresorptive medications: a systematic review.
Authors: Nicolatou-Galitis, Ourania, Kouri, Maria, Papadopoulou, Erofili, Vardas, Emmanouil, Galiti, Dimitra, Epstein, Joel B., Elad, Sharon, Campisi, Giuseppina, Tsoukalas, Nikolaos, Bektas-Kayhan, Kivanc, Tan, Winston, Body, Jean-Jacques, Migliorati, Cesar, Lalla, Rajesh V., for the MASCC Bone Study Group, MASCC Bone Study Group
Source: Supportive Care in Cancer; Feb2019, Vol. 27 Issue 2, p383-394, 12p
Subject Terms: OSTEONECROSIS, JAW necrosis, META-analysis, ANTINEOPLASTIC agents, PROTEIN-tyrosine kinase inhibitors, RAPAMYCIN, CANCER chemotherapy, CANCER patients
Abstract: Introduction: The reporting of osteonecrosis of the jaw (ONJ) related to anticancer agents without known antiresorptive properties (non-antiresorptives), such as antiangiogenics, tyrosine kinase inhibitors, mammalian target of rapamycin inhibitors, immune checkpoint inhibitors, and cytotoxic chemotherapy is increasing.Objective: To review characteristics of ONJ in cancer patients receiving non-antiresorptives.Methods: A systematic review of the literature between 2009 and 2017 was conducted by the Bone Study Group of MASCC/ISOO.Results: Of 6249 articles reviewed and from personal communication, 42 ONJ cases related to non-antiresorptives were identified. No gender predilection was noted. Median age was 60 years and ONJ stage 2 was most common, with predilection for posterior mandible. Exposed bone, pain, and infection were common at diagnosis. In comparison to bone targeting agents (BTAs), radiology, histology, and management were similar, with medication often discontinued. Delayed diagnosis (median 8 weeks) was noted. Important differences included earlier time to ONJ onset (median 20 weeks), absence of trigger event (40%), and greater likelihood of healing and shorter healing time (median 8 weeks) as compared to BTA-related ONJ. Gastrointestinal cancers predominated, followed by renal cell carcinomas compared to breast, followed by prostate cancers in BTA-related ONJ, reflecting different medications.Conclusions: Data about non-antiresorptive-related ONJ is sparse. This type of ONJ may have better prognosis compared to the BTA-related ONJ, suggested by greater likelihood of healing and shorter healing time. However, the delay in diagnosis highlights the need for more education. This is the first attempt to characterize ONJ associated with different non-antiresorptives, including BRAF and immune checkpoint inhibitors. [ABSTRACT FROM AUTHOR]
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Database: Complementary Index
More Details
ISSN:09414355
DOI:10.1007/s00520-018-4501-x
Published in:Supportive Care in Cancer
Language:English