@article{3122615,
    title = "Osteonecrosis of the jaw related to non-antiresorptive medications: a systematic review",
    author = "Nicolatou-Galitis, O. and Kouri, M. and Papadopoulou, E. and Vardas, E. and Galiti, D. and Epstein, J.B. and Elad, S. and Campisi, G. and Tsoukalas, N. and Bektas-Kayhan, K. and Tan, W. and Body, J.-J. and Migliorati, C. and Lalla, R.V. and for the MASCC Bone Study Group",
    journal = "Supportive Care in Cancer",
    year = "2019",
    volume = "27",
    number = "2",
    pages = "383-394",
    publisher = "Springer-Verlag",
    issn = "0941-4355, 1433-7339",
    doi = "10.1007/s00520-018-4501-x",
    keywords = "angiogenesis inhibitor;  checkpoint kinase inhibitor;  cytotoxic agent;  mammalian target of rapamycin inhibitor;  protein tyrosine kinase inhibitor;  bisphosphonic acid derivative;  bone density conservation agent, bone infection;  bone pain;  cancer patient;  clinical outcome;  delayed diagnosis;  digestive system cancer;  healing;  histology;  human;  jaw osteonecrosis;  priority journal;  prostate cancer;  renal cell carcinoma;  Review;  systematic review;  adult;  aged;  bone necrosis;  female;  jaw;  jaw osteonecrosis;  male;  middle aged;  pathology, Adult;  Aged;  Bisphosphonate-Associated Osteonecrosis of the Jaw;  Bone Density Conservation Agents;  Diphosphonates;  Female;  Humans;  Jaw;  Male;  Middle Aged;  Osteonecrosis",
    abstract = "Introduction: The reporting of osteonecrosis of the jaw (ONJ) related to anticancer agents without known antiresorptive properties (non-antiresorptives), such as antiangiogenics, tyrosine kinase inhibitors, mammalian target of rapamycin inhibitors, immune checkpoint inhibitors, and cytotoxic chemotherapy is increasing. Objective: To review characteristics of ONJ in cancer patients receiving non-antiresorptives. Methods: A systematic review of the literature between 2009 and 2017 was conducted by the Bone Study Group of MASCC/ISOO. Results: Of 6249 articles reviewed and from personal communication, 42 ONJ cases related to non-antiresorptives were identified. No gender predilection was noted. Median age was 60 years and ONJ stage 2 was most common, with predilection for posterior mandible. Exposed bone, pain, and infection were common at diagnosis. In comparison to bone targeting agents (BTAs), radiology, histology, and management were similar, with medication often discontinued. Delayed diagnosis (median 8 weeks) was noted. Important differences included earlier time to ONJ onset (median 20 weeks), absence of trigger event (40%), and greater likelihood of healing and shorter healing time (median 8 weeks) as compared to BTA-related ONJ. Gastrointestinal cancers predominated, followed by renal cell carcinomas compared to breast, followed by prostate cancers in BTA-related ONJ, reflecting different medications. Conclusions: Data about non-antiresorptive-related ONJ is sparse. This type of ONJ may have better prognosis compared to the BTA-related ONJ, suggested by greater likelihood of healing and shorter healing time. However, the delay in diagnosis highlights the need for more education. This is the first attempt to characterize ONJ associated with different non-antiresorptives, including BRAF and immune checkpoint inhibitors. © 2018, Springer-Verlag GmbH Germany, part of Springer Nature."
}