Molecular targeted drugs affect the development of antiresorptive‐related osteonecrosis of the jaw in patients with lung and kidney cancers

The use of antiresorptive agents in patients with cancer is strongly associated with the development of medication-related osteonecrosis of the jaw, with an incidence of ≥10%. Despite the presence of clinical position papers on this issue, the incidence of medication-related osteonecrosis of the jaw has not decreased. Therefore, we believe there are some unknown underlying factors, so we focused on the use of anticancer agents, especially molecular targeted drugs, in this study. We retrospectively evaluated the data of 366 patients who received antiresorptive agents for metastatic cancer treatment. All patients received proper oral care before antiresorptive agent initiation. Of the 366 patients, 48 (13.1%) developed medication-related osteonecrosis of the jaw. Medication-related osteonecrosis of the jaw developed in 18/55 (32.7%) patients who received molecular targeted drugs and in 30/311 (9.6%) patients who did not (p < 0.001). Among patients with lung cancer, 10/29 (34.5%) patients who received molecular targeted drugs and 5/96 (5.2%) who did not (p < 0.001) developed medication-related osteonecrosis of the jaw. In patients with kidney cancer, medication-related osteonecrosis of the jaw developed in 5/11 patients (45.5%) who received molecular targeted drugs and not in any of the 13 patients who did not (p < 0.01). Molecular targeted drugs significantly affect the development of medication-related osteonecrosis of the jaw. Therefore, in cancer treatment, close attention should be paid to antiresorptive agent use and to the details of anticancer therapies for managing medication-related osteonecrosis of the jaw.