Search results for " Denosumab"
showing 10 items of 25 documents
Early onset ONJ in patient treated with denosumab and bevacizumab: case report
2016
Molecular target therapy for bone metastasis : starting a new era with denosumab, a RANKL inhibitor
2014
Abstract: Introduction: The skeleton is generally the primary, and sometimes the only, site of metastasis in patients with advanced solid tumors. Bone metastases are the most frequent cause of cancer-related pain and the origin of severe morbidity in patients. Among the treatment options available for the prevention of skeletal-related events (SREs) associated with bone metastasis, zoledronic acid, an antiresorptive treatment from the group of bisphosphonates, is currently the standard of care in this setting. Areas covered: Zoledronic acid, together with denosumab (a monoclonal antibody against the receptor activator of nuclear factor kappa B ligand), is the most frequent approach for the …
New molecular targets in bone metastases.
2010
Bone metastases have a major impact on morbidity and on mortality in cancer patients. Despite its clinical relevance, metastasis remains the most poorly elucidated aspect of carcinogenesis. The biological mechanisms leading to bone metastasis establishment have been referred as " vicious circle," a complex network between cancer cells and the bone microenvironment. This review is aimed to underline the new molecular targets in bone metastases management other than bisphosphonates. Different pathways or molecules such as RANK/RANKL/OPG, cathepsin K, endothelin-1, Wnt/DKK1, Src have recently emerged as potential targets and nowadays preclinical and clinical trials are underway. The results fr…
Definition and estimation of osteonecrosis of jaw (ONJ), and optimal duration of antiresorptive treatment in bone metastatic cancer patients: supplem…
2017
To the Editor, In their recent article, Stopeck et al. [1] concluded that denosumab confirms its known safety profile even after longterm exposure, or after switching to it from zoledronic acid, and that osteonecrosis of jaws (ONJ) rates increased with increasing exposure to antiresorptives, consistent with previous reports. This is based on the open label extension phase of two phase 3 studies in patients with breast and prostate cancer with bone metastases who were randomized to receive denosumab or zoledronic acid (ZA) [2, 3]. The patients were offered open-label denosumab for up to an additional 2 years after the results of the primary analysis, favorable for denosumab on several aspect…
Simplifying the dental/periodontal management of patients with metabolic bone fragility receiving treatment with denosumab
2020
Denosumab (DNB) is a bone-targeted medication used to preserve structural integrity and minimise the risk of fragility fractures in metastatic cancer and metabolic bone disorders. DNB targets and binds RANK Ligand, inhibiting osteoclast maturation, function, and survival. In contrast with nitrogen-containing bisphosphonates (N-BPs), DNB does not bind to hydroxyapatite and incorporate into bone; thus, bone cellular remodelling recovers rapidly after drug suspension. Denosumab has benn linked to the occurrence of osteonecrosis of the jaw (MRONJ), a uncommon but severe oral side effect with a higher prevalence in metastatic cancer patients than in patients with metabolic bone fragility. Althou…
Adjuvant denosumab in early breast-cancer
2020
We read with interest the D-CARE trial report by Robert Coleman and colleagues1 on the adjuvant administration of denosumab in patients with early-stage breast cancer. Despite the negative results, which pose concerns about high dose denosumab schedules in an adjuvant setting, this large and well- designed trial can provide useful clinical data that are usually difficult to obtain from observational studies, particularly regarding medication- related osteonecrosis of the jaw (MRONJ).
Osteonecrosis of the Jaw in Myeloma Patients Receiving Denosumab or Zoledronic Acid. A Commentary of the Pivotal Trial by Raje et al. Published on La…
2018
The recent randomized trial, published by Raje et al., on Lancet Oncology is potentially practice changing. It proposes that denosumab is a valid alternative to zoledronic acid in the treatment of myeloma patients. However, several points need further data and more details, such as information on incidence, diagnosis, and follow-up of osteonecrosis of the jaw (ONJ) cases, observed among treated patients. Adopted definition to adjudicate ONJ cases, type of registration of potential ONJ cases, length of observation are possible causes of potential underestimation of ONJ incidence in their study. Future updated evaluations with longer follow-up, and including actuarial estimation, are required…
Early Denosumab for the prevention of osteoporotic fractures in breast cancer women undergoing aromatase inhibitors: A case-control retrospective stu…
2021
BACKGROUND: Aromatase inhibitors (AIs) might have a detrimental impact on bone health in breast cancer (BC) women. Denosumab has been shown to reduce the risk of fractures, but the appropriate time for starting is yet to be clearly defined. OBJECTIVE: To evaluate the effects of early treatment with Denosumab (⩽ 12 months after starting AIs) compared to a delayed treatment in BC women. METHODS: In this retrospective case-control study, we included medical records of BC post-menopausal women, treated with AIs therapy; they were divided as: study group (starting Denosumab ⩽ 12 months after AIs) and control group (> 12 months). At the baseline (T0) and at 18 months (T1), we evaluated the lum…
IL RANK LIGANDO QUALE TARGET TERAPEUTICO NEL TRATTAMENTO DELLE PAZIENTI ANZIANE CON OSTEOPOROSI
2013
Cortical and trabecular bone undergo a continuous and balanced remodeling process, which consists of a phase of resorption, mediated by osteoclasts, and a phase of neoformation mediated by osteoblasts. The activity of both, osteoblasts and osteoclasts, is regulated by the osteocytes, which are the most abundant cells in bone tissue. An imbalance of this process with an excessive resorption activity causes a loss of bone mass and microarchitectural deterioration of the skeleton, with consequent reduction of bone strength and increased risk of fractures. The ligand for the “Receptor Activator of Nuclear Factor Kappa- B” (RANK-L), a protein expressed by osteoblasts, plays a fundamental role in…