The use of denosumab (Xgeva) as an alternative to the more commonly prescribed zoledronic acid (Zometa) to slow down the development of bone metastases in men with advanced prostate cancer is becoming more common. The most common concern for men taking Zometa and now Xgeva has been osteonecrosis of the jaw. Osteonecrosis of the jaw is basically severe bone disease which is associated with bisphosphonate therapy (Zometa and now Xgeva).
One of the more common questions asked by many people is if osteonecrosis of the jaw is more or less common in men taking Zometa or Xgeva? The answer is simple; overall 2% of cancer patients treated with denosumab do developed jaw necrosis, which did not significantly different from the 1.45% incidence with Zometa.
According to a retrospective analysis of multiple randomized trials(1) of patients taking Xgeva, patients infrequently developed osteonecrosis of the jaw; however the rate appeared to increase over time in certain subgroups. Specifically, patients with breast and prostate cancers taking Xgeva were twice as likely to develop osteonecrosis of the jaw as treated patients with other solid tumors or multiple myeloma!
Tim van den Wyngaert, MD, of Antwerp University Hospital in Belgium, and colleagues concluded in a poster presentation at the International Conference on Cancer-Induced Bone Disease the longer treatment duration could explain the higher rates in patients with breast and prostate cancer patients. He said, “Current data suggest that additional gains in prevention