A new study evaluated the incidence of osteonecrosis of the jaw (ONJ) in patients with metastatic renal cell carcinoma (mRCC) treated with bone-targeted therapies (BTT). Results of this study were presented at the American Society of Clinical Oncology 2021 Genitourinary Cancers Symposium.

Skeletal-related events (SREs), which are associated with skeletal metastases, may be reduced by the use of BTT, but this treatment may increase susceptibility to ONJ, according to the researchers.

In this retrospective analysis of patients in Italy, the researchers evaluated the use of a BTT (zoledronic acid or denosumab) given in addition to concurrent or sequential treatment with either vascular endothelial growth factor-tyrosine kinase inhibitor (VEGF-TKI)-based therapy or immune-oncology (IO)-based treatment.

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A total of 74 patients who had bone metastases from mRCC were examined in this study. Of these patients, 57 received denosumab, and 17 were given zoledronic acid, with a median time of BTT exposure of 11.6 months.

The rate of ONJ in this study was 7.4%, and ONJ occurred in both first-line and second-line treatment settings. Among the 10 patients total who experienced ONJ, treatments that had been given during the time of ONJ diagnosis included sunitinib, cabozantinib, sorafenib, and nivolumab. One patient who developed ONJ was off therapy.

The researchers described the incidence of ONJ in this study as being higher than in 1 previous report of treatment with BTT in patients with mRCC treated with VEGF-TKI or IO, but also that it was lower than in some prior reports of patients with mRCC. The researchers recommended caution in the use of treatment combinations involving BTT and other therapies for mRCC.

Disclosures: Multiple authors declared affiliations with or received funding from the pharmaceutical industry. Please refer to the original abstract for a full list of disclosures.


Stellato M, Santini D, Sepe P, et al. Osteonecrosis of the jaw in metastatic renal cell carcinoma (mRCC) patients treated with zolendronic acid and denosumab: an observational retrospective multicenter trial. J Clin Oncol. 2021;39(suppl 6):abstr 299. doi:10.1200/JCO.2021.39.6_suppl.299

This article originally appeared on Oncology Nurse Advisor