Wiener Medizinische Wochenschrift

, Volume 158, Issue 23–24, pp 702–706

Bisphosphonate und Kiefernekrose – eine zunehmende Herausforderung in der Palliativmedizin

Themenschwerpunkt
  • 80 Downloads

Zusammenfassung

Knochenmetastasen sind eine der häufigsten Komplikationen bei malignen Erkrankungen. Bis zu 70 % der Mammakarzinome metastasieren in den Knochen [1]. Die Standardlangzeittherapie der Knochenmetastasen erfolgt durch Bisphosphonate. Diese wirksame Therapie kann jedoch mit erheblichen Nebenwirkungen behaftet sein. Die Bisphosphonat-induzierte Kiefenerkrose (ONJ = osteonecrosis of the jaw) ist eine erst kürzlich entdeckte unerwünschte Wirkung.

Schlüsselwörter

Knochenmetastasen Bisphosphonate Kiefernekrose 

Bisphosphonates and osteonecrosis of the jaw – an increasing challenge in palliative care

Summary

Bone metastases are one of the most common complications of cancer. Up to 70% of patients with advanced breast cancer metastasize to the bone [1]. The standard long-term treatment of bone metastases is bisphosphonates. This effective therapy, however, is able to cause serious side effects. Osteonecrosis of the jaw (ONJ) is a recently detected adverse outcome associated in rare cases with bisphosphonate therapy.

Keywords

Bone metastasis Bisphosphonates Osteonecrosis of the jaw 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

  1. Roodmann D. Mechanisms of bone metastasis. N Engl J Med, 350: 1655–1664, 2004CrossRefGoogle Scholar
  2. Body JJ. Breast cancer: bisphosphonate therapy for metastatic bone disease. Clin Cancer Res, 12: 6258–6263, 2006CrossRefGoogle Scholar
  3. Kohno N, Aogi K, Minami H, Nakamura S, Asaga T, Iino Y, Watanabe T, Goessl C, Ohashi Y, Takashima S. Zoledronic acid significantly reduces skeletal complications compared with placebo in Japanese women with bone metastases from breast cancer: a randomized, placebo-controlled trial. J Clin Oncol, 23: 3314–3321, 2005PubMedCrossRefGoogle Scholar
  4. Theriault RL, Lipton A, Hortobagyi GN, Leff R, Gluck S, Stewart JF, Costello S, Kennedy I, Simeone J, Seaman JJ, Knight RD, Mellars K, Heffernan M, Reitsma DJ. Pamidronate reduces skeletal morbidity in women with advanced breast cancer and lytic bone lesions: a randomized, placebo-controlled trial. Protocol 18 Aredia Breast Cancer Study Group. J Clin Oncol, 17: 846–854, 1999PubMedGoogle Scholar
  5. Gnant MF, Mlineritsch B, Luschin-Ebengreuth G, Grampp S, Kaessmann H, Schmid M, Menzel C, Piswanger-Soelkner JC, Galid A, Mittlboeck M, Hausmaninger H, Jakesz R. Zoledronic acid prevents cancer treatment-induced bone loss in premenopausal women receiving adjuvant endocrine therapy for hormone-responsive breast cancer: a report from the Austrian Breast and Colorectal Cancer Study Group. J Clin Oncol, 25: 820–828, 2007PubMedCrossRefGoogle Scholar
  6. Graham DY, Malaty HM, Goodgame R. Primary amino-bisphosphonates: a new class of gastrotoxic drugs-comparison of alendronate and aspirin. Am J Gastroenterol, 92: 1322–1325, 1997PubMedGoogle Scholar
  7. Göl D. Persistency with oral bisphosphonates in cancer patients. Proc ASCO Abstr 8221, 2005Google Scholar
  8. Marx R. Pamidronate (Aredia) and zoledronate (Zometa) induced avascular necrosis of the jaws: a growing epidemic. J Oral Maxillofac Surg, 61: 1115–1117, 2003PubMedCrossRefGoogle Scholar
  9. Bamias A, Kastritis E, Bamia C, Moulopoulos LA, Melakopoulos I, Bozas G, Koutsoukou V, Gika D, Anagnostopoulos A, Papadimitriou C, Terpos E, Dimopoulos MA. Osteonecrosis of the jaw in cancer after treatment with bisphosphonates: incidence and risk factors. J Clin Oncol, 23: 8580–8587, 2005PubMedCrossRefGoogle Scholar
  10. Kut V, Mehta J, Tariman J, Olsson A, Singhal S. Osteonecrosis of the jaw in myeloma patients receiving pamidronate or zoledronate. Blood, 104: 4933, 2004Google Scholar
  11. Dimopoulos MA, Kastritis E, Anagnostopoulos A, Melakopoulos I, Gika D, Moulopoulos LA, Bamia C, Terpos E, Tsionos K, Bamias A. Osteonecrosis of the jaw in patients with multiple myeloma treated with bisphosphonates: evidence of increased risk after treatment with zoledronic acid. Haematologica, 91: 968–971, 2006PubMedGoogle Scholar
  12. Sanna G, Preda L, Bruschini R, Cossu Rocca M, Ferretti S, Adamoli L, Verri E, Franceschelli L, Goldhirsch A, Nole F. Bisphosphonates and jaw osteonecrosis in patients with advanced breast cancer. Ann Oncol, 17: 1512–1516, 2006PubMedCrossRefGoogle Scholar
  13. Maerevoet M, Martin C, Duck L. Osteonecrosis of the jaw and bisphosphonates. N Engl J Med, 353: 99–102, 2005PubMedCrossRefGoogle Scholar
  14. Van den Wyngaert T, Huizing MT, Vermorken JB. Bisphosphonates and osteonecrosis of the jaw: cause and effect or a post hoc fallacy? Ann Oncol, 17: 1197–1204, 2006PubMedCrossRefGoogle Scholar
  15. Bilezikian JP. Osteonecrosis of the jaw. Do bisphosphonates pose a risk? N Engl J Med, 355: 2278–2281, 2006PubMedCrossRefGoogle Scholar
  16. Woo SB, Hellstein JW, Kalmar JR. Narrative [corrected] review: bisphosphonates and osteonecrosis of the jaws. Ann Intern Med, 144: 753–761, 2006PubMedGoogle Scholar
  17. Zervas K, Verrou E, Teleioudis Z, Vahtsevanos K, Banti A, Mihou D, Krikelis D, Terpos E. Incidence, risk factors and management of osteonecrosis of the jaw in patients with multiple myeloma: a single-centre experience in 303 patients. Br J Haematol, 134: 620–623, 2006PubMedCrossRefGoogle Scholar
  18. Lin JH. Bisphosphonates: a rewiev of their pharmakokinetic properties. Bone, 18: 75–85, 1996PubMedCrossRefGoogle Scholar
  19. Chukwujindu J, Dolin P, Hoffmann-La Roche LTD. Welwyn Garden City, United Kingdom. ESMO, 2006Google Scholar
  20. Santini D, Vincenzi B, Dicuonzo G, Avvisati G, Massacesi C, Battistoni F, Gavasci M, Rocci L, Tirindelli MC, Altomare V, Tocchini M, Bonsignori M, Tonini G. Zoledronic acid induces significant and long-lasting modifications of circulating angiogenic factors in cancer patients. Clin Cancer Res, 9: 2893–2897, 2003PubMedGoogle Scholar
  21. Ruggiero S, Gralow J, Marx RE, Hoff AO, Schubert M, Huryn JM, Toth B, Damato K, Valero V. Practical guidelines for the prevention, diagnosis, and treatment of osteonecrosis of the jaw in patients with cancer. J Oncol Practice, 2: 7–14, 2006CrossRefGoogle Scholar
  22. Nastro E, Musolino C, Allegra A, Oteri G, Cicciu M, Alonci A, Quartarone E, Alati C, De Ponte FS. Bisphosphonate-associated osteonecrosis of the jaw in patients with multiple myeloma and breast cancer. Acta Haematol, 117: 181–187, 2007PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  1. 1.Interne AbteilungKrankenhaus der Barmherzigen Brüder WienWienAustria
  2. 2.Onkologische AbteilungWilhelminenspital der Stadt WienWienAustria

Personalised recommendations