Maxillary osteonecrosis linked to Pembrolizumab therapy: a case report

Introduction: Osteonecrosis of the jaw is a serious condition often associated with the use of bone-modifying agents or antiangiogenics. Recent evidence suggests that immune checkpoint inhibitors, including Pembrolizumab, might also contribute to osteonecrosis of the jaw. Observation: An 83-year-old...

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Main Authors: Gosselin-Rousselle Louise, Gaudimier Zoé, Pamelard Pierre-Olivier, Sader Paul, Moizan Hervé
Format: Article
Language:English
Published: EDP Sciences 2024-01-01
Series:Journal of Oral Medicine and Oral Surgery
Subjects:
Online Access:https://www.jomos.org/articles/mbcb/full_html/2024/03/mbcb240188/mbcb240188.html
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author Gosselin-Rousselle Louise
Gaudimier Zoé
Pamelard Pierre-Olivier
Sader Paul
Moizan Hervé
author_facet Gosselin-Rousselle Louise
Gaudimier Zoé
Pamelard Pierre-Olivier
Sader Paul
Moizan Hervé
author_sort Gosselin-Rousselle Louise
collection DOAJ
description Introduction: Osteonecrosis of the jaw is a serious condition often associated with the use of bone-modifying agents or antiangiogenics. Recent evidence suggests that immune checkpoint inhibitors, including Pembrolizumab, might also contribute to osteonecrosis of the jaw. Observation: An 83-year-old male with metastatic non-small cell lung cancer treated exclusively with Pembrolizumab developed osteonecrosis of the maxilla. Management included sequestrectomy, curettage, placement of Platelet-rich-Fibrin (PRF) and antibiotics. Despite initial improvement, symptoms recurred. The patient eventually stabilized but passed away a few months later. Discussion: A literature review was conducted supporting the hypothesis that the mechanism may involve disrupted bone remodeling due to enhanced immune activity. This highlights the need for further research to clarify the potential association between Pembrolizumab and osteonecrosis, and to develop preventive and management strategies. Conclusion: While definitive causality between Pembrolizumab and osteonecrosis of the jaw cannot be established with the current evidence, this case adds to the growing body of literature suggesting that immune checkpoint inhibitors may be implicated in the pathogenesis of osteonecrosis of the jaw. As the use of immunotherapy expands in oncology, further research is essential to elucidate this association and provide guidelines.
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series Journal of Oral Medicine and Oral Surgery
spelling doaj-art-c70d95a58d6646908c9947aed261946b2025-02-07T08:24:38ZengEDP SciencesJournal of Oral Medicine and Oral Surgery2608-13262024-01-013033810.1051/mbcb/2024041mbcb240188Maxillary osteonecrosis linked to Pembrolizumab therapy: a case reportGosselin-Rousselle Louise0Gaudimier Zoé1Pamelard Pierre-Olivier2Sader Paul3Moizan Hervé4Service d'odontologie CHU de RouenService d'odontologie CHU de CréteilService d'odontologie CH du HavreService d'odontologie CHU de RouenService d'odontologie CHU de RouenIntroduction: Osteonecrosis of the jaw is a serious condition often associated with the use of bone-modifying agents or antiangiogenics. Recent evidence suggests that immune checkpoint inhibitors, including Pembrolizumab, might also contribute to osteonecrosis of the jaw. Observation: An 83-year-old male with metastatic non-small cell lung cancer treated exclusively with Pembrolizumab developed osteonecrosis of the maxilla. Management included sequestrectomy, curettage, placement of Platelet-rich-Fibrin (PRF) and antibiotics. Despite initial improvement, symptoms recurred. The patient eventually stabilized but passed away a few months later. Discussion: A literature review was conducted supporting the hypothesis that the mechanism may involve disrupted bone remodeling due to enhanced immune activity. This highlights the need for further research to clarify the potential association between Pembrolizumab and osteonecrosis, and to develop preventive and management strategies. Conclusion: While definitive causality between Pembrolizumab and osteonecrosis of the jaw cannot be established with the current evidence, this case adds to the growing body of literature suggesting that immune checkpoint inhibitors may be implicated in the pathogenesis of osteonecrosis of the jaw. As the use of immunotherapy expands in oncology, further research is essential to elucidate this association and provide guidelines.https://www.jomos.org/articles/mbcb/full_html/2024/03/mbcb240188/mbcb240188.htmlpembrolizumabosteonecrosismaxilla
spellingShingle Gosselin-Rousselle Louise
Gaudimier Zoé
Pamelard Pierre-Olivier
Sader Paul
Moizan Hervé
Maxillary osteonecrosis linked to Pembrolizumab therapy: a case report
Journal of Oral Medicine and Oral Surgery
pembrolizumab
osteonecrosis
maxilla
title Maxillary osteonecrosis linked to Pembrolizumab therapy: a case report
title_full Maxillary osteonecrosis linked to Pembrolizumab therapy: a case report
title_fullStr Maxillary osteonecrosis linked to Pembrolizumab therapy: a case report
title_full_unstemmed Maxillary osteonecrosis linked to Pembrolizumab therapy: a case report
title_short Maxillary osteonecrosis linked to Pembrolizumab therapy: a case report
title_sort maxillary osteonecrosis linked to pembrolizumab therapy a case report
topic pembrolizumab
osteonecrosis
maxilla
url https://www.jomos.org/articles/mbcb/full_html/2024/03/mbcb240188/mbcb240188.html
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AT saderpaul maxillaryosteonecrosislinkedtopembrolizumabtherapyacasereport
AT moizanherve maxillaryosteonecrosislinkedtopembrolizumabtherapyacasereport