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Single-center analysis of antiresorptive agent-related osteonecrosis of the jaw in lung cancer patients.

Authors
  • Okamura, Misato1
  • Fujita, Kohei1
  • Yamamoto, Yuki1, 2
  • Kanai, Osamu1
  • Nakatani, Koichi1
  • Horimoto, Kanna3
  • Hashimoto, Masayuki3
  • Sawai, Satoru3
  • Shimosato, Maiko4
  • Yoshida, Kazuya4
  • Mio, Tadashi1
  • 1 Division of Respiratory Medicine, Center for Respiratory Diseases, National Hospital Organization Kyoto Medical Center, Kyoto, Japan. , (Japan)
  • 2 Department of Drug Discovery for Lung Diseases, Graduate School of Medicine, Kyoto University, Kyoto, Japan. , (Japan)
  • 3 Division of Thoracic Surgery, Center for Respiratory Diseases, National Hospital Organization Kyoto Medical Center, Kyoto, Japan. , (Japan)
  • 4 Department of Oral and Maxillofacial Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan. , (Japan)
Type
Published Article
Journal
Asia-Pacific journal of clinical oncology
Publication Date
Dec 01, 2020
Volume
16
Issue
6
Pages
380–384
Identifiers
DOI: 10.1111/ajco.13395
PMID: 32893984
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Over the past two decades, antiresorptive agent-related osteonecrosis of the jaw (ARONJ) has become a growing concern. We examined the incidence of ARONJ and identified its risk factors in lung cancer patients in the real-world clinical setting. To our knowledge, we are the first to do so. We retrospectively analyzed lung cancer patients with bone metastases who had received anti-resorptive agents (zoledronate or denosumab) at the National Hospital Organization Kyoto Medical Center from October 2012 to September 2018. All ARONJ cases were diagnosed by the dentists according to the established diagnostic criteria. A total of 171 patients were reviewed, 13 (7.6%) of whom experienced ARONJ. Among the 13 patients, six (46.2%), four (30.8%) and three (23.1%) had adenocarcinoma, squamous carcinoma and not otherwise specified, respectively. ARONJ was stage 2 in three (23.1%) patients and stage 3 in 10 (76.9%). More cycles of antiresorptive agents (odds ratio [OR] = 11.54; 95% confidence interval [CI], 2.47-53.99; P < 0.01), use of immune checkpoint inhibitors (ICIs; OR = 5.05; 95% CI, 1.56-16.37; P < 0.01) and longer survival duration (≥2 years; OR = 12.16; 95% CI, 3.17-46.65; P < 0.01) were independently associated with ARONJ in a multivariate analysis. The incidence of ARONJ was relatively high in lung cancer patients with bone metastases. When using antiresorptive agents, oncologists should closely monitor patients for ARONJ during the course of treatment and regularly consult with dentists, especially in patients receiving ICIs. © 2020 John Wiley & Sons Australia, Ltd.

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