Cancer-induced hypercalcemia

Franco Lumachi, Antonella Brunello, Anna Roma, Umberto Basso

Research output: Contribution to journalArticle

86 Citations (Scopus)

Abstract

Cancer-induced hypercalcemia (CIH) occurs in 5% to 30% of patients with cancer during the course of their disease, depending on the type of tumor. This review provides information on the pathophysiology and treatment of CIH. Enhanced bone resorption is the primary cause of CIH and the release of tumor-derived mediators induces this increase in osteoclast-mediated resorption. The interactions between osteoclasts and cancer cells are mainly mediated by parathyroid hormone-related protein (PTHrP), that activates osteoblasts to produce receptor activator of nuclear factor- K ligand (RANKL) and osteoclast precursors, with subsequent bone osteolysis. Low parathyroid hormone serum levels together with high calcium levels in a cancer patient may suggest a CIH. There are two different therapeutic approaches for treating CIH, to increase the urinary excretion of calcium, or to inhibit osteoclastic bone resorption, RANKL or the action of PTHrP. Inpatients with CIH the first step of therapy is usually to restore renal function which is often impaired due to dehydration. Bisphosphonates administration is at present the main-stay of treatment, while calcitonin, gallium nitrate and mithramycin have limited activity and several side-effects. Anti-RANKL therapy (denosumab) and antibodies against PTHrP are promising therapies, but their clinical use should be further explored to more clearly document the effects.

Original languageEnglish
Pages (from-to)1551-1555
Number of pages5
JournalAnticancer Research
Volume29
Issue number5
Publication statusPublished - May 2009

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Hypercalcemia
Neoplasms
Parathyroid Hormone-Related Protein
Osteoclasts
Cytoplasmic and Nuclear Receptors
gallium nitrate
Bone Resorption
Ligands
Therapeutics
Plicamycin
Calcium
Osteolysis
Diphosphonates
Calcitonin
Parathyroid Hormone
Osteoblasts
Dehydration
Inpatients
Kidney
Bone and Bones

Keywords

  • Bisphosphonates
  • Cancer
  • Hypercalcemia
  • Malignancy
  • PTHrP
  • RANKL
  • Review

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Lumachi, F., Brunello, A., Roma, A., & Basso, U. (2009). Cancer-induced hypercalcemia. Anticancer Research, 29(5), 1551-1555.

Cancer-induced hypercalcemia. / Lumachi, Franco; Brunello, Antonella; Roma, Anna; Basso, Umberto.

In: Anticancer Research, Vol. 29, No. 5, 05.2009, p. 1551-1555.

Research output: Contribution to journalArticle

Lumachi, F, Brunello, A, Roma, A & Basso, U 2009, 'Cancer-induced hypercalcemia', Anticancer Research, vol. 29, no. 5, pp. 1551-1555.
Lumachi F, Brunello A, Roma A, Basso U. Cancer-induced hypercalcemia. Anticancer Research. 2009 May;29(5):1551-1555.
Lumachi, Franco ; Brunello, Antonella ; Roma, Anna ; Basso, Umberto. / Cancer-induced hypercalcemia. In: Anticancer Research. 2009 ; Vol. 29, No. 5. pp. 1551-1555.
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