Osteonecrosis of the Jaw and Angiogenesis inhibitors: A Revival of a Rare but Serous Side Effect

Title:Osteonecrosis of the Jaw and Angiogenesis inhibitors: A Revival of a Rare but Serous Side Effect

Volume: 24 Issue: 28

Author(s): Lorenzo Antonuzzo *, Alice Lunghi , Paolo Petreni , Marco Brugia , Alice Laffi , Elisa Giommoni , Marinella M. Mela , Francesca Mazzoni , Vanni Balestri and Francesco Di Costanzo

Affiliation:

• Medical Oncology Unit, Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50139 Firenze,Italy

Keywords: Osteonecrosis of the jaw, bisphosphonates, angiogenesis, anti-angiogenic drug, anti-VEGF, pathogenesis.

Abstract: Osteonecrosis of the jaw (ONJ) is a rare treatment related side effect that was firstly described in 2002 through a case report in metastatic bone cancer patient treated with bisphosphonates (BPs) therapy. ONJ is defined as an eight weeks or longer clinical finding of exposed bone in the oral cavity without response to appropriate therapy. The diagnosis is mainly clinical but often requires a radiological confirmation with an orthopantomography. So it must be made by a dental specialist with sufficient experience on ONJ and requires a detailed anamnestic exploration of comorbidities and treatments history. In particular, ONJ affects a wide number of oncologic patients treated with BPs for bone metastatic cancers and, more recently, with anti-angiogenic drugs. The aim of this this paper is to describe diagnosis and classification of this rare but serious side effect and its pathophysiology. In particular, we provide a detailed description of clinical evidences upon the relationship between anti-angiogenic drugs and ONJ. Considering the evolving of cancer epidemiology with a greater number of cancer surviving patients, this side effect always deserves more attention. We conclude that ONJ must be always carefully investigated and prevented with a multidisciplinary approach involving oncologist, radiation oncologist and skilled dental practitioner when a cancer patient must begin a BP or an antiangiogenic treatment.

Cite this article as:

Antonuzzo Lorenzo *, Lunghi Alice , Petreni Paolo , Brugia Marco , Laffi Alice, Giommoni Elisa , Mela M. Marinella , Mazzoni Francesca, Balestri Vanni and Costanzo Di Francesco , Osteonecrosis of the Jaw and Angiogenesis inhibitors: A Revival of a Rare but Serous Side Effect, Current Medicinal Chemistry 2017; 24 (28) . https://dx.doi.org/10.2174/0929867324666170511113811