Should Vitamin D Level be Measured Before Denosumab in Patients with Castration-Resistant Metastatic Prostate Cancer to Prevent Hypocalcemia?
Atike Gokcen Demiray1, Arzu Yaren1, Burcu Yapar Taskoylu1, Serkan Degirmencioglu1, Gamze Gokoz Dogu1, Umut Cakiroglu1, Nail Ozhan1, Canan Karan1, Burcin Cakan Demirel1, Tolga Dogan1, Melek Ozdemir11Department of Medical Oncology, Pamukkale University Faculty of Medicine, Denizli, Turkey
Objectives: Denosumab reduces skeletal related events in castration-resistant metastatic prostate cancer (CRMPC) with bone metastases.It is recommended to give calcium and vitamin D to prevent hypocalcemia after denosumab. There is no recommendation to check vitamin D and the specific level of vitamin D that should not be given before denosumab. We aimed to show that the rate of hypocalcemia is high even in vitamin D deficiency alone in the absence of other risk factors for hypocalcemia and can be reduced by checking vitamin D before the administration or by adjusting the dose of denosumab according to the vitamin D, which are not included in denosumab product information (PI). Methods: We retrospectively analyzed 40 CRMPC patients who received subcutaneous injections of 120 mg denosumab. Results: 28 patients had vitamin D deficiency before treatment. Patients with vitamin D deficiency had a higher rate of hypocalcemia (87.5% vs 16.6%). Hypocalcemia was significantly higher in patients with vitamin D deficiency (p:0.001). In patients with vitamin D deficiency, 87.5% grade1, 8.3% grade 2 and 4.1% grade 3 hypocalcemia developed. Conclusion: Vitamin D should be checked before treatment to prevent denosumab-related hypocalcemia. New studies should be planned for this recommendation to be in the denosumab PI. Keywords: Denosumab, hypocalcemia, prostate cancer, vitamin D
Cite This Article
Demiray A, Yaren A, Taskoylu B, Degirmencioglu S, Dogu G, Cakiroglu U, Ozhan N, Karan C, Demirel B, Dogan T, Ozdemir M. Should Vitamin D Level be Measured Before Denosumab in Patients with Castration-Resistant Metastatic Prostate Cancer to Prevent Hypocalcemia?. EJMI. 2021; 5(3): 313-316
Corresponding Author: Atike Gokcen Demiray