Jaw osteonecrosis associated with aflibercept, irinotecan and fluorouracil: attention to oral district

Tumori
Agostino PonzettiPatrizia Racca

Abstract

The antiangiogenic monoclonal antibody aflibercept in association with fluorouracil and irinotecan improves the survival of patients with metastatic colorectal cancer (mCRC) treated previously with oxaliplatin-based therapy. Multiple reports raised the hypothesis that the concomitant use of antiresorptive drugs and antiangiogenic drugs may increase the risk of osteonecrosis of the jaw (ONJ). Some reports have been published regarding cases of ONJ during treatment with bevacizumab for mCRC. Here we describe the first reported case of ONJ occurring in a 64-year-old woman with untreated periodontitis and episodic previous pyorrhea occurring during treatment with aflibercept plus FOLFIRI during the expanded-access program. This case report warrants further investigation into the potential association between the use of anti-VEGF agents and ONJ. Given the serious nature of ONJ, we recommend that particular attention be paid to the oral district prior to treating patients and during treatment with chemotherapy and targeted agents, especially anti-VEGF agents. Such measures could also be useful in reducing the incidence of stomatitis.

Citations

Apr 15, 2016·Expert Opinion on Drug Safety·V FuscoG Campisi
Jul 9, 2016·Journal of the National Cancer Institute·Vittorio FuscoAlberto Bedogni
Oct 26, 2018·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Ourania Nicolatou-GalitisUNKNOWN MASCC Bone Study Group
Feb 23, 2017·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Emmanuelle VigariosVincent Sibaud
Jul 25, 2019·Einstein·Raquel D'Aquino Garcia CaminhaPaulo Sérgio da Silva Santos
Mar 9, 2019·Journal of the Korean Association of Oral and Maxillofacial Surgeons·Antonio Fabrizio NifosìGianfilippo Nifosì
Mar 30, 2020·British Dental Journal·Rebecca KingVinod Patel
Jun 14, 2019·Journal of Oral Pathology & Medicine : Official Publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology·Leanne TeohMichael John McCullough

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NCT00561470

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