TY - JOUR
T1 - Incidence of Medication-Related Osteonecrosis of the Jaw in Patients With Breast Cancer During a 20-Year Follow-Up
T2 - A Population-Based Multicenter Retrospective Study
AU - Brunner, Christine
AU - Arvandi, Marjan
AU - Marth, Christian
AU - Egle, Daniel
AU - Baumgart, Florentina
AU - Emmelheinz, Miriam
AU - Walch, Benjamin
AU - Lercher, Johanna
AU - Iannetti, Claudia
AU - Wöll, Ewald
AU - Pechlaner, Agnes
AU - Zabernigg, August
AU - Volgger, Birgit
AU - Castellan, Maria
AU - Andraschofsky, Oliver Tibor
AU - Markl, Alice
AU - Hubalek, Michael
AU - Schnallinger, Michael
AU - Puntscher, Sibylle
AU - Siebert, Uwe
AU - Schönherr, Sebastian
AU - Forer, Lukas
AU - Bruckmoser, Emanuel
AU - Laimer, Johannes
PY - 2025/1/10
Y1 - 2025/1/10
N2 - PURPOSE: Medication-related osteonecrosis of the jaw (MRONJ) is one of the most important toxicities of antiresorptive therapy, which is standard practice for patients with breast cancer and bone metastases. However, the population-based incidence of MRONJ is not well established. We therefore performed a retrospective multicenter study to assess the incidence for a whole Austrian federal state (Tyrol).MATERIALS AND METHODS: This retrospective multicenter study was conducted between 2000 and 2020 at all nine breast centers across Tyrol, Austria. Using the cancer registry, the total Tyrolean population was screened for all patients with breast cancer. All patients with breast cancer and bone metastases receiving antiresorptive therapy were finally included in the study.RESULTS: From 8,860 patients initially screened, 639 individuals were eligible and included in our study. Patients received antiresorptive therapy once per month without de-escalation of therapy. MRONJ was diagnosed in 56 (8.8%, 95% CI, 6.6 to 11.0) patients. The incidence of MRONJ was 11.6% (95% CI, 8.0 to 15.3) in individuals treated with denosumab only, 2.8% (95% CI, 0.7 to 4.8) in those treated with bisphosphonates only, and 16.3% (95% CI, 8.8 to 23.9) in the group receiving bisphosphonates followed by denosumab. Individuals developed MRONJ significantly earlier when treated with denosumab. Time to MRONJ after treatment initiation was 4.6 years for individuals treated with denosumab only, 5.1 years for individuals treated with bisphosphonates only, and 8.4 years for individuals treated with both consecutively.CONCLUSION: MRONJ incidence in breast cancer patients with bone metastases was found to be considerably higher, especially for patients receiving denosumab, when compared with available data in the literature. Additionally, patients treated with denosumab developed MRONJ significantly earlier.
AB - PURPOSE: Medication-related osteonecrosis of the jaw (MRONJ) is one of the most important toxicities of antiresorptive therapy, which is standard practice for patients with breast cancer and bone metastases. However, the population-based incidence of MRONJ is not well established. We therefore performed a retrospective multicenter study to assess the incidence for a whole Austrian federal state (Tyrol).MATERIALS AND METHODS: This retrospective multicenter study was conducted between 2000 and 2020 at all nine breast centers across Tyrol, Austria. Using the cancer registry, the total Tyrolean population was screened for all patients with breast cancer. All patients with breast cancer and bone metastases receiving antiresorptive therapy were finally included in the study.RESULTS: From 8,860 patients initially screened, 639 individuals were eligible and included in our study. Patients received antiresorptive therapy once per month without de-escalation of therapy. MRONJ was diagnosed in 56 (8.8%, 95% CI, 6.6 to 11.0) patients. The incidence of MRONJ was 11.6% (95% CI, 8.0 to 15.3) in individuals treated with denosumab only, 2.8% (95% CI, 0.7 to 4.8) in those treated with bisphosphonates only, and 16.3% (95% CI, 8.8 to 23.9) in the group receiving bisphosphonates followed by denosumab. Individuals developed MRONJ significantly earlier when treated with denosumab. Time to MRONJ after treatment initiation was 4.6 years for individuals treated with denosumab only, 5.1 years for individuals treated with bisphosphonates only, and 8.4 years for individuals treated with both consecutively.CONCLUSION: MRONJ incidence in breast cancer patients with bone metastases was found to be considerably higher, especially for patients receiving denosumab, when compared with available data in the literature. Additionally, patients treated with denosumab developed MRONJ significantly earlier.
KW - Humans
KW - Breast Neoplasms/drug therapy
KW - Female
KW - Retrospective Studies
KW - Incidence
KW - Bisphosphonate-Associated Osteonecrosis of the Jaw/epidemiology
KW - Aged
KW - Middle Aged
KW - Bone Density Conservation Agents/adverse effects
KW - Bone Neoplasms/secondary
KW - Follow-Up Studies
KW - Austria/epidemiology
KW - Denosumab/adverse effects
KW - Aged, 80 and over
KW - Adult
KW - Diphosphonates/adverse effects
U2 - 10.1200/JCO.24.00171
DO - 10.1200/JCO.24.00171
M3 - Original Article
C2 - 39163561
SN - 0732-183X
VL - 43
SP - 180
EP - 188
JO - JOURNAL OF CLINICAL ONCOLOGY
JF - JOURNAL OF CLINICAL ONCOLOGY
IS - 2
ER -