Toxicity of Bone-Targeted Agents in Malignancy

  • Caroline Wilson
  • Fiona Taylor
  • Robert ColemanEmail author


The bisphosphonates have been in clinical use for three decades. During this time the adverse event profile and favorable risk-benefit ratio have become clearly defined and strategies identified for minimizing the impact of these side effects on patients. More recently, denosumab has been incorporated into clinical practice and so far demonstrated mild and treatable side effects. Long-term adverse events are infrequent but merit special attention.

In this chapter we review the side effects of the four bisphosphonates licensed for use in malignancy, including clodronate, ibandronate, pamidronate, and zoledronic acid as well as the new targeted agent, denosumab.


Bisphosphonates Zoledronic acid Denosumab Toxicity Acute phase reactions Renal impairment Osteonecrosis of the jaw Atypical femoral fracture 


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© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Academic Unit of Clinical OncologyWeston Park Hospital, University of SheffieldSheffieldUK

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