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Open Access 01-06-2018 | Original Article

A multicenter case registry study on medication-related osteonecrosis of the jaw in patients with advanced cancer

Authors: Morten Schiodt, Saroj Vadhan-Raj, Mark S. Chambers, Ourania Nicolatou-Galitis, Constantinus Politis, Ruxandra Coropciuc, Stefano Fedele, Danielle Jandial, Jeffrey Zhang, Haijun Ma, Deborah P. Saunders

Published in: Supportive Care in Cancer | Issue 6/2018

Abstract

Purpose

This observational case registry study was designed to describe the natural history of cancer patients with medication-related osteonecrosis of the jaw (ONJ) and evaluate the ONJ resolution rate.

Methods

Adults with a diagnosis of cancer and with a new diagnosis of ONJ were enrolled and evaluated by a dental specialist at baseline and every 3 months for 2 years and then every 6 months for 3 years until death, consent withdrawal, or loss to follow-up. The primary endpoint was the rate and time course of ONJ resolution. Secondary endpoints included frequency of incident ONJ risk factors, ONJ treatment patterns, and treatment patterns of antiresorptive agents for subsequent ONJ.

Results

Overall, 327 patients were enrolled; 207 (63%) were continuing on study at data cutoff. Up to 69% of evaluable patients with ONJ had resolution or improvement during the study. ONJ resolution (AAOMS ONJ staging criteria) was observed in 114 patients (35%); median (interquartile range) time from ONJ onset to resolution was 7.3 (4.5–11.4) months. Most patients (97%) had received antiresorptive medication before ONJ development, 9 patients (3%) had not; 68% had received zoledronic acid, 38% had received denosumab, and 10% had received pamidronate (56% had received bisphosphonates only, 18% had received denosumab only, and 21% had exposure to both).

Conclusions

These results are consistent with those observed in clinical trials evaluating skeletal-related events in patients with advanced malignancy involving bone. Longer follow-up will provide further information on ONJ recurrence and resolution rates between medically and surgically managed patients.

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Title: A multicenter case registry study on medication-related osteonecrosis of the jaw in patients with advanced cancer
Authors: Morten Schiodt
Saroj Vadhan-Raj
Mark S. Chambers
Ourania Nicolatou-Galitis
Constantinus Politis
Ruxandra Coropciuc
Stefano Fedele
Danielle Jandial
Jeffrey Zhang
Haijun Ma
Deborah P. Saunders
Publication date: 01-06-2018
Publisher: Springer Berlin Heidelberg
Published in: Supportive Care in Cancer / Issue 6/2018
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-017-4003-2

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