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Anti-VEGFR therapy is one of the healing inhibitors of antiresorptive-related osteonecrosis of the jaw

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Abstract

Introduction

Antiresorptive-related osteonecrosis of the jaw (ARONJ) is a rare but serious adverse event associated with bone-modifying agents (BMAs) and affects patients in the terminal stages of cancer. Molecular targeting drugs (MTDs), anti-vascular endothelial growth factor receptor (VEGFR), and anti-epidermal growth factor receptor (EGFR) drugs are essential in various cancer treatments, although MTDs are risk factors for ARONJ. However, the mechanism through which MTDs affect treatment prognosis of ARONJ remains unclear. Therefore, we investigated the potential inhibitory factors for healing in the conservative therapy of ARONJ with a focus on MTDs.

Materials and methods

Sixty patients who were administered BMAs for the treatment of malignancies and who underwent conservative treatment for ARONJ were assessed. The healing rate of ARONJ for each risk factor was retrospectively evaluated.

Results

Among the 60 patients, 27 were male and 33 were female. The median age was 67 years, and the median follow-up period was 292 (range 91–1758) days. The healing rate was lower in those treated with both zoledronic acid (Za) and denosumab (Dmab) than in those treated with Za or Dmab alone (0% vs. 28.8%, p = 0.03). Regarding the administration of MTDs, the treatment rate with anti-VEGFR drugs was 7.1% (p = 0.04), anti-EGFR drugs was 12.5% (p = 0.18), and without MTDs was 36.8%.

Conclusion

In the conservative treatment of ARONJ, the administration of several BMAs and anti-VEGFR drugs was the factor contributing to the inhibition of healing.

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Acknowledgements

We thank Editage (www.editage.jp) for their English language editing service.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Oral and Maxillofacial Surgery, Fukushima Medical University Hospital, 1 Hikarigaoka, Fukushima City, Fukushima,, 960-1295, Japan

    Chihiro Kanno, Tetsuharu Kaneko, Manabu Endo, Takehiro Kitabatake, Tomoko Sakuma, Yoshiaki Kanaya, Yuki Watanabe & Hiroshi Hasegawa

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  1. Chihiro Kanno
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  2. Tetsuharu Kaneko
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  3. Manabu Endo
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  4. Takehiro Kitabatake
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  7. Yuki Watanabe
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  8. Hiroshi Hasegawa
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Contributions

Each author contributed to this study. Study concept: CK, KT, and HH Study design: CK and HH Data acquisition: CK, ME, TK, Y.K., and YW Quality control: TS and TK Data analysis and interpretation: CK, YK, and YW Statistical analysis: CK and TK Manuscript preparation and editing: CK and HH Manuscript review: HH and TK

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Correspondence to Hiroshi Hasegawa.

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All authors have no conflicts of interest.

Ethics approval

Ethical approval was obtained from the institutional review board of Fukushima Medical University Hospital (No. General 2020-010), and the study conformed to the tenets of the Declaration of Helsinki.

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Kanno, C., Kaneko, T., Endo, M. et al. Anti-VEGFR therapy is one of the healing inhibitors of antiresorptive-related osteonecrosis of the jaw. J Bone Miner Metab 39, 423–429 (2021). https://doi.org/10.1007/s00774-020-01170-6

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  • DOI: https://doi.org/10.1007/s00774-020-01170-6

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