Top

memo - Magazine of European Medical Oncology

Published in:

03-11-2023 | Hypercalcemia | short review

Management of malignant hypercalcemia in cancer patients—a short review

Authors: Clemens Petrasch, MD, Petra Marics, Thomas Spanberger

Published in: memo - Magazine of European Medical Oncology | Issue 4/2023

Summary

Hypercalcemia of malignancy (HCM) can be the first symptom leading to diagnosis and initiation of treatment in cancer patients. This short review presents a real-life case, discusses its validity in light of recent recommendations and guidelines, and ultimately aims to give a comprehensive overview how to treat and avoid common pitfalls in HCM.

Al-Batran SE, Hartmann JT, Hofheinz R, Homann N, Rethwisch V, Probst S, Stoehlmacher J, Clemens MR, Mahlberg R, Fritz M, Seipelt G, Sievert M, Pauligk C, Atmaca A, Jäger E. Biweekly fluorouracil, leucovorin, oxaliplatin, and docetaxel (FLOT) for patients with metastatic adenocarcinoma of the stomach or esophagogastric junction: a phase II trial of the Arbeitsgemeinschaft Internistische Onkologie. Ann Oncol. 2008;19(11):1882–7. https://doi.org/10.1093/annonc/mdn403.CrossRefPubMed

Wang-Gillam A, Li CP, Bodoky G, Dean A, Shan YS, Jameson G, Macarulla T, Lee KH, Cunningham D, Blanc JF, Hubner RA, Chiu CF, Schwartsmann G, Siveke JT, Braiteh F, Moyo V, Belanger B, Dhindsa N, Bayever E, Von Hoff DD, Chen LT, NAPOLI‑1 Study Group. Nanoliposomal irinotecan with fluorouracil and folinic acid in metastatic pancreatic cancer after previous gemcitabine-based therapy (NAPOLI-1): a global, randomised, open-label, phase 3 trial. Lancet. 2016;387(10018):545–57. https://doi.org/10.1016/S0140-6736(15)00986-1. Erratum in: Lancet. 2016 Feb 6;387(10018):536.CrossRefPubMed

Burris HA 3rd, Moore MJ, Andersen J, Green MR, Rothenberg ML, Modiano MR, Cripps MC, Portenoy RK, Storniolo AM, Tarassoff P, Nelson R, Dorr FA, Stephens CD, Von Hoff DD. Improvements in survival and clinical benefit with gemcitabine as first-line therapy for patients with advanced pancreas cancer: a randomized trial. J Clin Oncol. 1997;15(6):2403–13. https://doi.org/10.1200/JCO.1997.15.6.2403.CrossRefPubMed

Payne RB, Little AJ, Williams RB, Milner JR. Interpretation of serum calcium in patients with abnormal serum proteins. Br Med J. 1973;4(5893):643–6. https://doi.org/10.1136/bmj.4.5893.643.CrossRefPubMedPubMedCentral

Kyle RA, Gertz MA, Witzig TE, Lust JA, Lacy MQ, Dispenzieri A, Fonseca R, Rajkumar SV, Offord JR, Larson DR, Plevak ME, Therneau TM, Greipp PR. Review of 1027 patients with newly diagnosed multiple myeloma. Mayo Clin Proc. 2003;78(1):21–33. https://doi.org/10.4065/78.1.21.CrossRefPubMed

Jick S, Li L, Gastanaga VM, Liede A. Prevalence of hypercalcemia of malignancy among cancer patients in the UK: analysis of the Clinical Practice Research Datalink database. Cancer Epidemiol. 2015;39(6):901–7. https://doi.org/10.1016/j.canep.2015.10.012.CrossRefPubMed

Dalemo S, Eggertsen R, Hjerpe P, Jansson S, Almqvist EG, Bengtsson Boström K. Long-term follow-up of patients with elevated serum calcium concentrations in Swedish primary care. Scand J Prim Health Care. 2013;31(4):248–54. https://doi.org/10.3109/02813432.2013.861152.CrossRefPubMedPubMedCentral

Hamilton F, Carroll R, Hamilton W, Salisbury C. The risk of cancer in primary care patients with hypercalcaemia: a cohort study using electronic records. Br J Cancer. 2014;111(7):1410–2. https://doi.org/10.1038/bjc.2014.433.CrossRefPubMedPubMedCentral

Goldner W. Cancer-related hypercalcemia. J Oncol Pract. 2016;12(5):426–32. https://doi.org/10.1200/JOP.2016.011155.CrossRefPubMed

10.

Clines GA. Mechanisms and treatment of hypercalcemia of malignancy. Curr Opin Endocrinol Diabetes Obes. 2011;18(6):339–46. https://doi.org/10.1097/MED.0b013e32834b4401.CrossRefPubMed

11.

Hosking DJ, Cowley A, Bucknall CA. Rehydration in the treatment of severe hypercalcaemia. QJM Int J Med. 1981;50(4):473–81. https://doi.org/10.1093/oxfordjournals.qjmed.a067700.CrossRef

12.

LeGrand SB, Leskuski D, Zama I. Narrative review: furosemide for hypercalcemia: an unproven yet common practice. Ann Intern Med. 2008;149(4):259–63. https://doi.org/10.7326/0003-4819-149-4-200808190-00007.CrossRefPubMed

13.

Chevallier B, Peyron R, Basuyau JP, Bastit P, Comoz M. Calcitonine humaine dans les hypercalcémies néoplasiques. Résultats d’un essai prospectif randomisé [Human calcitonin in neoplastic hypercalcemia. Results of a prospective randomized trial]. Presse Med. 1988;17(45):2375–7. French.PubMed

14.

Major P, Lortholary A, Hon J, Abdi E, Mills G, Menssen HD, Yunus F, Bell R, Body J, Quebe-Fehling E, Seaman J. Zoledronic acid is superior to pamidronate in the treatment of hypercalcemia of malignancy: a pooled analysis of two randomized, controlled clinical trials. J Clin Oncol. 2001;19(2):558–67. https://doi.org/10.1200/JCO.2001.19.2.558.CrossRefPubMed

15.

Ikesue H, Doi K, Morimoto M, Hirabatake M, Muroi N, Yamamoto S, Takenobu T, Hashida T. Risk evaluation of denosumab and zoledronic acid for medication-related osteonecrosis of the jaw in patients with bone metastases: a propensity score-matched analysis. Support Care Cancer. 2022;30(3):2341–8. https://doi.org/10.1007/s00520-021-06634-7.CrossRefPubMed

16.

Hu MI, Glezerman IG, Leboulleux S, Insogna K, Gucalp R, Misiorowski W, Yu B, Zorsky P, Tosi D, Bessudo A, Jaccard A, Tonini G, Ying W, Braun A, Jain RK. Denosumab for treatment of hypercalcemia of malignancy. J Clin Endocrinol Metab. 2014;99(9):3144–52. https://doi.org/10.1210/jc.2014-1001.CrossRefPubMedPubMedCentral

17.

El-Hajj Fuleihan G, et al. Treatment of hypercalcemia of malignancy in adults: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2023;108(3):507–28. https://doi.org/10.1210/clinem/dgac621.CrossRefPubMed

18.

Diel IJ, Body JJ, Stopeck AT, Vadhan-Raj S, Spencer A, Steger G, von Moos R, Goldwasser F, Feng A, Braun A. The role of denosumab in the prevention of hypercalcaemia of malignancy in cancer patients with metastatic bone disease. Eur J Cancer. 2015;51(11):1467–75. https://doi.org/10.1016/j.ejca.CrossRefPubMed

19.

Kimberg DV, Baerg RD, Gershon E, Graudusius RT. Effect of cortisone treatment on the active transport of calcium by the small intestine. J Clin Invest. 1971;50(6):1309–21. https://doi.org/10.1172/JCI106610.CrossRefPubMedPubMedCentral

20.

Seymour JF, Gagel RF. Calcitriol: the major humoral mediator of hypercalcemia in Hodgkin’s disease and non-Hodgkin’s lymphomas. Blood. 1993;82(5):1383–94.CrossRefPubMed

21.

Binstock ML, Mundy GR. Effect of Calcitonin and Glucocorticoids in combination on the Hypercalcemia of malignancy. Ann Intern Med.1980(93):269–72. https://doi.org/10.7326/0003-4819-93-2-269.

Title: Management of malignant hypercalcemia in cancer patients—a short review
Authors: Clemens Petrasch, MD
Petra Marics
Thomas Spanberger
Publication date: 03-11-2023
Publisher: Springer Vienna
Keywords: Hypercalcemia
Denosumab
Bisphosphonate
Denosumab
Zoledronic Acid
Published in: memo - Magazine of European Medical Oncology / Issue 4/2023
Print ISSN: 1865-5041
Electronic ISSN: 1865-5076
DOI: https://doi.org/10.1007/s12254-023-00919-9

Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras

Prof. Fabrice Barlesi

Developed by: Springer Medicine

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Summary

Please log in to get access to this content

Other articles of this Issue 4/2023

ASCO 2023: new treatment options in CNS tumors

Second-line treatment of HER2-positive advanced gastroesophageal adenocarcinoma

HER2 in focus—gastric cancer

Focal therapy in intermediate- and high-risk prostate cancer

Essential news from ASCO 2023 in primary resectable and advanced or metastatic pancreatic cancer

Prostate cancer special—part 1

Keynote webinar | Spotlight on antibody–drug conjugates in cancer