Worsening of osteonecrosis of the jaw during treatment with sunitinib in a patient with metastatic renal cell carcinoma

Antonella Brunello, Giorgia Saia, Alberto Bedogni, Daniela Scaglione, Umberto Basso

Research output: Contribution to journalArticle

Abstract

We report on the potential association of suspected bisphosphonate-associated osteonecrosis of the jaw (BRONJ) recurrence with the use of the novel antiangiogenic drug sunitinib. A 59 year-old patient affected by metastatic renal cell carcinoma (RCC) and established BRONJ experienced consecutive episodes of painful jaw infection with cutaneous fistula and bone sequestration which occurred during active treatment with sunitinib, improved after discontinuation and antibiotic therapy, then rapidly worsened with resumption of sunitinib. We hypothesize that the potent antiangiogenic activity of sunitinib may amplify the inhibition of bone remodeling exerted by aminobisphosphonates entrapped within the osteonecrotic mineral matrix, antagonize mucosal healing and expose to infections during treatment. This supports the emerging role of soft-tissue damage in the pathogenesis of osteonecrosis of the jaw.

Original languageEnglish
Pages (from-to)173-175
Number of pages3
JournalBone
Volume44
Issue number1
DOIs
Publication statusPublished - Jan 2009

Keywords

  • Bisphosphonates
  • Metastatic renal cell carcinoma
  • Osteonecrosis of the jaw
  • Sunitinib
  • Tyrosine kinase inhibitors

ASJC Scopus subject areas

  • Physiology
  • Endocrinology, Diabetes and Metabolism
  • Histology

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