Incidence of Medication-Related Osteonecrosis of the Jaw in Patients With Breast Cancer During a 20-Year Follow-Up: A Population-Based Multicenter Retrospective Study-Reference-Cited by-同舟云学术

Incidence of Medication-Related Osteonecrosis of the Jaw in Patients With Breast Cancer During a 20-Year Follow-Up: A Population-Based Multicenter Retrospective Study

Published:2024-08-20 Issue: Volume: Page:
ISSN:0732-183X
Container-title:Journal of Clinical Oncology
language:en
Short-container-title:JCO

Author:

Brunner Christine¹^ORCID,Arvandi Marjan²,Marth Christian¹^ORCID,Egle Daniel¹^ORCID,Baumgart Florentina¹,Emmelheinz Miriam¹^ORCID,Walch Benjamin³,Lercher Johanna³,Iannetti Claudia⁴,Wöll Ewald⁵,Pechlaner Agnes⁵,Zabernigg August⁶,Volgger Birgit⁷^ORCID,Castellan Maria⁷,Andraschofsky Oliver Tibor⁸,Markl Alice⁹,Hubalek Michael¹⁰,Schnallinger Michael¹¹,Puntscher Sibylle²^ORCID,Siebert Uwe²¹²¹³,Schönherr Sebastian¹⁴,Forer Lukas¹⁴,Bruckmoser Emanuel¹⁵^ORCID,Laimer Johannes³

Affiliation:

1. Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria

2. Department of Public Health, Health Services Research and Health Technology Assessment, Medical Decision Making and Health Technology Assessment, Institute of Public Health, UMIT TIROL—University for Health Sciences and Technology, Hall in Tirol, Austria

3. Department of Cranio-Maxillofacial and Oral Surgery, Medical University of Innsbruck, Innsbruck, Austria

4. Department of Visceral, Transplant and Thoracic Surgery (VTT), Center of Operative Medicine, Medical University of Innsbruck, Innsbruck, Austria

5. Department of Internal Medicine, St Vinzenz Hospital, Zams, Austria

6. Department of Internal Medicine, County Hospital Kufstein, Kufstein, Austria

7. Department of Obstetrics and Gynecology, County Hospital Lienz, Lienz, Austria

8. Department of Obstetrics and Gynecology, State Hospital Hall, Hall, Austria

9. Department of Visceral Surgery, State Hospital Hall, Hall, Austria

10. Department of Obstetrics and Gynecology, County Hospital Schwaz, Schwaz, Austria

11. Department of Internal Medicine, County Hospital St Johann, St Johann, Austria

12. Departments of Health Policy & Management and Epidemiology, Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, MA

13. Institute for Technology Assessment and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA

14. Division of Genetic Epidemiology, Department of Medical Genetics, Molecular and Clinical Pharmacology, Medical University of Innsbruck, Innsbruck, Austria

15. Private Practice for Oral and Maxillofacial Surgery, Salzburg, Austria

Abstract

PURPOSE Medication-related osteonecrosis of the jaw (MRONJ) is one of the most important toxicities of antiresorptive therapy, which is standard practice for patients with breast cancer and bone metastases. However, the population-based incidence of MRONJ is not well established. We therefore performed a retrospective multicenter study to assess the incidence for a whole Austrian federal state (Tyrol). MATERIALS AND METHODS This retrospective multicenter study was conducted between 2000 and 2020 at all nine breast centers across Tyrol, Austria. Using the cancer registry, the total Tyrolean population was screened for all patients with breast cancer. All patients with breast cancer and bone metastases receiving antiresorptive therapy were finally included in the study. RESULTS From 8,860 patients initially screened, 639 individuals were eligible and included in our study. Patients received antiresorptive therapy once per month without de-escalation of therapy. MRONJ was diagnosed in 56 (8.8%, 95% CI, 6.6 to 11.0) patients. The incidence of MRONJ was 11.6% (95% CI, 8.0 to 15.3) in individuals treated with denosumab only, 2.8% (95% CI, 0.7 to 4.8) in those treated with bisphosphonates only, and 16.3% (95% CI, 8.8 to 23.9) in the group receiving bisphosphonates followed by denosumab. Individuals developed MRONJ significantly earlier when treated with denosumab. Time to MRONJ after treatment initiation was 4.6 years for individuals treated with denosumab only, 5.1 years for individuals treated with bisphosphonates only, and 8.4 years for individuals treated with both consecutively. CONCLUSION MRONJ incidence in breast cancer patients with bone metastases was found to be considerably higher, especially for patients receiving denosumab, when compared with available data in the literature. Additionally, patients treated with denosumab developed MRONJ significantly earlier.

Publisher

American Society of Clinical Oncology (ASCO)

Link

https://ascopubs.org/doi/pdfdirect/10.1200/JCO.24.00171

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