Thosani Sonali, Hu Mimi I
Department of Endocrine Neoplasia & Hormonal Disorders, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Future Oncol. 2015;11(21):2865-71. doi: 10.2217/fon.15.232. Epub 2015 Sep 25.
Hypercalcemia of malignancy is an oncologic emergency due to tumoral factors that stimulate osteoclast-mediated bone resorption. It requires a combination of recommended treatments (i.e., hydration, bisphosphonate and calcitonin), which may be deleterious in patients with compromised cardiac or renal function or may not control serum calcium levels long term. Recurrent or refractory hypercalcemia may preclude the use of chemotherapeutic agents needed to effectively treat the underlying cancer, which is the cause of hypercalcemia. Denosumab, a fully human monoclonal antibody against RANKL, inhibits the maturation, function and survival of osteoclasts. An open-label, single-arm study of denosumab in patients with hypercalcemia of malignancy despite recent bisphosphonate treatment revealed positive results. Thus, the US FDA recently approved denosumab for the indication of hypercalcemia of malignancy, increasing the options available for patients with this debilitating and life-threatening condition.
恶性肿瘤高钙血症是一种肿瘤急症，由刺激破骨细胞介导的骨吸收的肿瘤因素引起。它需要联合使用推荐的治疗方法（即补液、双膦酸盐和降钙素），这些方法对心脏或肾功能受损的患者可能有害，或者可能无法长期控制血清钙水平。复发性或难治性高钙血症可能会妨碍使用有效治疗潜在癌症（高钙血症的病因）所需的化疗药物。地诺单抗是一种针对核因子κB受体活化因子配体（RANKL）的全人单克隆抗体，可抑制破骨细胞的成熟、功能和存活。一项针对尽管近期接受了双膦酸盐治疗但仍患有恶性肿瘤高钙血症患者的开放标签、单臂地诺单抗研究显示出阳性结果。因此，美国食品药品监督管理局（US FDA）最近批准地诺单抗用于治疗恶性肿瘤高钙血症，增加了针对这种使人衰弱且危及生命疾病患者的可用治疗选择。
