Denosumab May Be Effective Against Hypercalcemia of Malignancy

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NEW ORLEANS—Subcutaneous denosumab is associated with strong serum calcium responses among patients with hypercalcemia of malignancy (HCM) following intravenous (IV) bisphosphonate treatment, according to a single-arm, open-label study. The results were reported at the 55th American Society of Hematology Annual Meeting and Exposition.

“In this study…100% of patients with hematologic malignancies responded to denosumab by day 10,” reported a team of researchers led by Rasim Gucalp, MD, of the Montefiore Medical Center in the Bronx, NY.

A total of 33 patients were enrolled in the study, of whom only nine had hematologic malignancies (five myeloma, two non-Hodgkin lymphoma, two chronic lymphocytic leukemia [CLL] with Richter's transformation), and with whose data the new ad-hoc analysis was conducted.

Patients received subcutaneous denosumab (120 mg) on days 1, 8, 15 and 29, and every 4 weeks thereafter. Treatment response was defined as corrected serum calcium (CSC) of 11.5 mg/dL or higher by day 10 of denosumab treatment.

By day 10, all nine patients with hematologic malignancies had responses to treatment, and five had a complete response. “Eight of the nine patients with hematologic malignancies (89%) had a complete response over the course of the study,” the coauthors noted.

Disease progression was reported in two patients (22%) and worsened hypercalcemia in one patient (11%). No participant developed osteonecrosis of the jaw.

“Denosumab may offer a new treatment option for patients who have HCM that is refractory to bisphosphonates,” concluded Dr. Gucalp.

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