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"No reported treatment has proven successful for osteonecrosis of the jaw, which means for now the focus is on prevention or alleviating symptoms once it develops. We do not know how to predict who will develop ONJ or who is most at risk," says Van Poznak, a breast oncologist at the U-M Comprehensive Cancer Center who treats patients whose cancer has metastasized to bone.

"Some patients have resolution of the lesion but in other patients, it may remain stable or even progress," Van Poznak adds.

Patients with osteoporosis also take bisphosphonates, although their treatment is typically prescribed as a pill, rather than intravenously. Some cases of ONJ have been reported in patients with osteoporosis who are taking oral bisphosphonates, but the risk of ONJ to such patients appears to be very low.

Previous studies have noted anywhere from 0.6 percent to 10 percent of patients with cancer on bisphosphonates developed ONJ. Reporting is currently voluntary. The problem, Van Poznak says, is that the condition itself is poorly defined and no universal reporting mechanism exists.

To address these challenges, clinical trials are being designed to help better define the condition. These upcoming clinical trials investigating bisphosphonate therapy for advanced cancer will include monitoring for ONJ, and researchers hope to learn what causes the condition to develop.

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Contact: Nicole Fawcett
nfawcett@umich.edu
734-764-2220
University of Michigan Health System
2-Oct-2006