Osteonecrosis of the jaw: a rare but possible side effect in thyroid cancer patients treated with tyrosine-kinase inhibitors and bisphosphonates.
Osteonecrosis of the jaw
Sorafenib adverse event
Thyroid cancer
Tyrosine-kinase inhibitors therapy
Zoledronic acid
Journal
Journal of endocrinological investigation
ISSN: 1720-8386
Titre abrégé: J Endocrinol Invest
Pays: Italy
ID NLM: 7806594
Informations de publication
Date de publication:
Dec 2021
Dec 2021
Historique:
received:
18
03
2021
accepted:
07
07
2021
pubmed:
23
7
2021
medline:
19
2
2022
entrez:
22
7
2021
Statut:
ppublish
Résumé
Osteonecrosis of the jaw (ONJ) is a rare but very serious disease that can affect both jaws. It is defined as exposed bone in the maxillofacial region that does not heal within 8 weeks after a health care provider identification. ONJ can occur spontaneously or can be due to drugs like bisphosphonates (BPS) and anti-RANK agents, in patients with no history of external radiation therapy in the craniofacial region. Although in phase 3 trials of tyrosine kinase inhibitors (TKIs) used in thyroid cancer (TC) the ONJ was not reported among the most common side effects, several papers reported the association between ONJ and TKIs, both when they are used alone and in combination with a bisphosphonate. The appearance of an ONJ in a patient with metastatic radio-iodine refractory differentiated TC, treated with zoledronic acid and sorafenib, has put us in front of an important clinical challenge: when a ONJ occurred during TKIs treatment, it really worsens the patients' quality of life. We should consider that in the case of ONJ a TKI discontinuation becomes necessary, and this could lead to a progression of neoplastic disease. The most important aim of this review is to aware the endocrinologists/oncologists dealing with TC to pay attention to this possible side effect of BPS and TKIs, especially when they are used in association. To significantly reduced the risk of ONJ, both preventive measures before initiating not only antiresorptive therapy but also antiangiogenic agents, and regular dental examinations during the treatment should always be proposed.
Identifiants
pubmed: 34291429
doi: 10.1007/s40618-021-01634-0
pii: 10.1007/s40618-021-01634-0
pmc: PMC8572199
doi:
Substances chimiques
Antineoplastic Agents
0
Bone Density Conservation Agents
0
Protein Kinase Inhibitors
0
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
2557-2566Subventions
Organisme : Ministero dell'Istruzione, dell'Università e della Ricerca
ID : PRIN project 2017YTWKWH
Informations de copyright
© 2021. The Author(s).
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