Osteonecrosis of the jaws associated with protein kinase inhibitors: a systematic review

AbstractThis systematic review analysed evidence relating to medication-related osteonecrosis of the jaws (MRONJ) associated with protein kinase inhibitors in antiresorptive na ïve patients. A literature search of major biomedical databases was conducted in March 2020. Information extracted from relevant articles included bibliographic information, patient characteristics, MRONJ characteristics at diagnosis, management strategies and outcomes. Sixteen studies, representin g data from 17 patients, were included for final analysis. Descriptive statistics were used to synthesis available data. Eleven protein kinase inhibitors were implicated, with a mean exposure of 13 months prior to MRONJ. Renal cell carcinoma was the primary diagnosis in 41.2% of patients. Patient sy mptoms, clinical features, radiographic findings and histological findings were consistent with those previously described in patients with MRONJ associated with antiresorptive medications. Overall, there was a 75% rate of cure, with a mean healing time of 17.2 weeks. Patients were treated surgicall y in 53.3% of the cases. Patients treated surgically achieved complete healing in 100% of cases, compared with 58% in those treated conservatively. Drug discontinuation was reported in 69.2% of patients. Patients who had the offending drug discontinued achieved complete healing in 75% of cases, comp ared with 50% in those who did not. Evidence relating to MRONJ associated with protein kinase inhibitors is of low ...
Source: Oral and Maxillofacial Surgery - Category: ENT & OMF Source Type: research

Related Links:

A 53-year-old woman developed widespread tense bullae with pruritus and oral mucosal lesions recalcitrant to corticosteroids during a treatment with pembrolizumab for stage IV renal cell carcinoma that persisted after discontinuation of the drug. ESR and CRP levels were elevated and biopsy suggested an autoimmune bullous process, but direct immunofluorescence results were negative. What is the diagnosis and what would you do next?
Source: JAMA - Journal of the American Medical Association - Category: General Medicine Source Type: research
The treatment of advanced renal cell carcinoma has changed dramatically since 2005 with the approval of 12 regimens including oral, intravenous, and combination strategies. These approvals have changed the treatment paradigm for these patients and developed new challenges and a critical role for oncology nurses to ensure that the treatment plan and adverse events are managed effectively. The majority of these regimens include an oral anticancer drug, which requires patients and their caregivers to understand the medication, the potential adverse events, the importance of medicine adherence, and the importance of early and ...
Source: The Cancer Journal - Category: Cancer & Oncology Tags: Review Articles Source Type: research
Abstract The treatment of advanced renal cell carcinoma has changed dramatically since 2005 with the approval of 12 regimens including oral, intravenous, and combination strategies. These approvals have changed the treatment paradigm for these patients and developed new challenges and a critical role for oncology nurses to ensure that the treatment plan and adverse events are managed effectively. The majority of these regimens include an oral anticancer drug, which requires patients and their caregivers to understand the medication, the potential adverse events, the importance of medicine adherence, and the import...
Source: Cancer Journal - Category: Cancer & Oncology Authors: Tags: Cancer J Source Type: research
AbstractWe encountered a 55-year-old Japanese man with advanced renal cell carcinoma and slowly progressive type 1 diabetes mellitus (SPT1DM), whose insulin secretory capacity was drastically reduced for a brief period after only one cycle of immune checkpoint inhibitor (ICI) treatment. The patient had been diagnosed with type 2 diabetes at the age of 53  years and was treated using oral hypoglycemic agents. However, 2 years later, he was diagnosed with SPT1DM and autoimmune thyroiditis, based on the presence of anti-glutamic acid decarboxylase antibodies (GADA) and thyroid autoantibodies, which was accompanied b...
Source: Diabetology International - Category: Endocrinology Source Type: research
Abstract BACKGROUND: Antiangiogenic treatments play an important role in the therapeutic strategy for metastatic renal cell carcinoma. Apatinib is an oral tyrosine kinase inhibitor that targets vascular endothelial growth factor receptor-2. We aimed to assess the efficacy and safety of apatinib therapy in metastatic renal cell carcinoma patients. METHODS: Between January 2018 and November 2018, we enrolled 53 metastatic renal cell carcinoma patients. Apatinib was administered at an initial dose of 500 mg once daily. The disease control rate, objective response rate, progression-free survival, and adverse even...
Source: Urologic Oncology - Category: Urology & Nephrology Authors: Tags: Urol Oncol Source Type: research
CONCLUSIONS: LOX has a 'pro-neoplastic' effect as it modulates the host stroma to favour increasing tumour mass and worsening prognosis. Increased expression of LOX causes increased collagen fibre cross-linkage that 'stiffens' the stromal matrix. This increases compressive stresses contributing to tissue hypoxia that elevates Rho GTPase-dependent cytoskeletal tension leading to erratic tumour cell morphogenesis that in turn confers motility to these cells resulting in metastasis. Inhibitors of LOX can potentially down-regulate LOX levels in the tumour micro-environment by controlling tissue hypoxia and curtailing the produ...
Source: Minerva Stomatologica - Category: Dentistry Tags: Minerva Stomatol Source Type: research
Renal cell carcinoma metastasis to the oral cavity is rare. Significantly, the oral lesion in this case was the first indication of a malignant disease in the patient. This case underscores the importance of detailed history taking, interpretation of clinical finding, and high index of suspicion for metastatic disease to the oral cavity. AbstractRenal cell carcinoma metastasis to the oral cavity is rare. Significantly, the oral lesion in this case was the first indication of a malignant disease in the patient. This case underscores the importance of detailed history taking, interpretation of clinical finding, and high inde...
Source: Clinical Case Reports - Category: General Medicine Authors: Tags: CASE REPORT Source Type: research
Abstract In various cancers, high-grade tumor and poor survival rate in patients with upregulated lncRNAs UCA1 have been confirmed. Urothelial carcinoma associated 1 (UCA1) is an oncogenic non-coding RNA with a length of more than 200 nucleotides. The UCA1 regulate critical biological processes that are involved in cancer progression, including cancer cell growth, invasion, migration, metastasis, and angiogenesis. So It should not surprise that UCA1 overexpresses in variety of cancers type, including pancreatic cancer, ovarian cancer, gastric cancer, colorectal cancer, breast cancer, prostate cancer, endometrial c...
Source: Current Molecular Medicine - Category: Molecular Biology Authors: Tags: Curr Mol Med Source Type: research
CONCLUSION: This study showed that the use of a natural multicomponent mouthwash coupled with regular oral hygiene was able to reduce the severity and duration of everolimus-induced stomatitis in patients with RCC. TRIAL REGISTRATION NUMBER: ISRCTN14568888. PMID: 32364051 [PubMed - as supplied by publisher]
Source: Tumori - Category: Cancer & Oncology Tags: Tumori Source Type: research
Abstract Recombinant interleukin-2 (rIL-2) is indicated for metastatic renal cell carcinoma and melanoma. Over recent years low-dose rIL-2 has been studied for the treatment of autoimmune diseases and acute coronary syndrome because of its ability to expand and activate T regulatory (Treg) cells. However, several medical conditions potentially benefiting from rIL-2 administrations are characterized by an intrinsic prothrombotic risk, thus requiring concurrent anticoagulation. In our systematic review of the literature, we investigated the potential for drug interactions between oral anticoagulants and rIL-2 by ass...
Source: Hamostaseologie - Category: Hematology Authors: Tags: Hamostaseologie Source Type: research
More News: Cancer & Oncology | Carcinoma | Databases & Libraries | ENT & OMF | Kidney Cancer | Oral Cancer | Radiography | Renal Cell Carcinoma | Statistics | Study