A real-world study on the prevalence and risk factors of medication related osteonecrosis of the jaw in cancer patients with bone metastases treated with Denosumab

Assessing the incidence of Medication Related Osteonecrosis of the Jaw (MRONJ) in cancer patients with bone metastases receiving Denosumab (Dmab) and identifying potential risk factors. A retrospective observational study on consecutive cancer patients with bone metastases, who received at least one...

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Bibliographic Details
Published in:Cancer medicine (Malden, MA) MA), 2023-09, Vol.12 (17), p.18317-18326
Main Authors: Bracchi, Paola, Zecca, Ernesto, Brunelli, Cinzia, Miceli, Rosalba, Tinè, Gabriele, Maniezzo, Massimo, Lo Dico, Silvia, Caputo, Mariangela, Shkodra, Morena, Caraceni, Augusto T
Format: Article
Language:English
Subjects:
Bisphosphonates
Bone cancer
bone metastasis
cancer
Cancer therapies
Chemotherapy
Denosumab
Dependent variables
Diabetes
Disease prevention
Endocrine therapy
Jaw
Metastases
Metastasis
Multivariate analysis
Necrosis
Oral hygiene
Osteonecrosis
osteonecrosis of the jaw
Patients
Prostate cancer
Regression analysis
Risk factors
Statistical analysis
Toxicity
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Summary:Assessing the incidence of Medication Related Osteonecrosis of the Jaw (MRONJ) in cancer patients with bone metastases receiving Denosumab (Dmab) and identifying potential risk factors. A retrospective observational study on consecutive cancer patients with bone metastases, who received at least one dose of Dmab and one follow-up visit. MRONJ crude cumulative incidence (CCI) was estimated considering death without MRONJ as competing event. Multiple regression models were used to study the association between MRONJ incidence and potential risk factors: age, cancer diagnosis, previous bisphosphonates, dental treatments before starting Dmab, extraction or other dental treatment during Dmab, chemotherapy, hormone therapy, and antiangiogenic (AA) agents concurrent use. On 780 patients included (median follow-up 17 months), 54% and 18% had, respectively, breast and prostate cancer. The mean number of Dmab administration was 12. Fifty-six patients developed MRONJ with a 24- and a 48-month crude cumulative incidence of 5.7% (95% Cl: 4.2%-7.8%) and 9.8% (95% CI: 7.6%-12.7%), respectively. Higher MRONJ incidence was significantly associated with middle aged group (>56 and ≤73), both at univariate and multivariate analysis (p = 0.029 and 0.0106). Dental treatments (Hazard Ratio [HR] = 3.67; p = 0.0001), dental extractions (HR = 23.40; p 
ISSN:2045-7634
2045-7634
DOI:10.1002/cam4.6429