Denosumab May Be Effective Against Hypercalcemia of Malignancy
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.