@article{7e20df47543a46aaa74c5ad1da23c0bf,
title = "Osteonecrosis of the jaw induced by treatment with anti-PD-1 immunotherapy: a case report",
abstract = "Recognizing rare but clinically significant toxicity of immunotherapy is critical. Here we describe the first detailed case of severe osteonecrosis of the jaw due to anti-PD-1. A 75-year-old man with metastatic melanoma, with no prior radiation or treatment with bone-targeting agents, experienced jaw pain 1 week after his first dose of nivolumab. Imaging studies were negative, and treatment was resumed after pain was controlled. 4 months later, the patient experienced acute exacerbation of pain and malocclusion of the jaw. Imaging showed bilateral fractures of the angle of mandible with extensive disruption of the normal trabecular architecture, requiring total mandibulectomy. The patient's metastatic melanoma responded to treatment and remains controlled >20 months after treatment cessation without further therapy.",
keywords = "anti-PD-1, checkpoint inhibitors, fracture, immunotherapy, melanoma, nivolumab, osteonecrosis",
author = "Xerxes Pundole and Jones, {Amy Little} and Tetzlaff, {Michael T.} and Williams, {Michelle D.} and Murphy, {William A.} and Adegbenga Otun and Goepfert, {Ryan P.} and Davies, {Michael A.}",
note = "Funding Information: MT Tetzlaff has served on the scientific advisory board of Myriad Genetics, Novartis LLC, Nanostring and Merck, unrelated to the submitted work. MD Williams has served on the scientific advisory board of Bayer, unrelated to the submitted work. MA Davies has been a consultant to Roche/Genentech, Array, Novartis, BMS, GSK, Sanofi-Aventis, Syndax, Apexigen and Vaccinex, and he has been the PI of funded research grants to his institution by Roche/Genentech, GSK, Astrazeneca, Sanofi-Aventis, Merck, Myriad and Oncothyreon. MA Davies acknowledges support from the NIH/NCI (2T32CA009666-25), the Dr Miriam and Sheldon G Adelson Medical Research Foundation, the AIM at Melanoma Foundation and philanthropic contributions to the Melanoma Moon Shots Program of MD Anderson. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. No writing assistance was utilized in the production of this manuscript. Funding Information: MT Tetzlaff has served on the scientific advisory board of Myriad Genetics, Novartis LLC, Nanostring and Merck, unrelated to the submitted work. MDWilliams has served on the scientific advisory board of Bayer, unrelated to the submitted work. MA Davies has been a consultant to Roche/Genentech, Array, Novartis, BMS, GSK, Sanofi-Aventis, Syndax, Apexigen and Vaccinex, and he has been the PI of funded research grants to his institution by Roche/Genentech, GSK, Astrazeneca, Sanofi-Aventis, Merck, Myriad and Oncothyreon. MA Davies acknowledges support from the NIH/NCI (2T32CA009666-25), the Dr Miriam and Sheldon G Adelson Medical Research Foundation, the AIM at Melanoma Foundation and philanthropic contributions to the Melanoma Moon Shots Program of MD Anderson. Publisher Copyright: {\textcopyright} 2020 Future Medicine Ltd.",
year = "2020",
month = dec,
doi = "10.2217/imt-2020-0108",
language = "English (US)",
volume = "12",
pages = "1213--1219",
journal = "Immunotherapy",
issn = "1750-743X",
publisher = "Future Medicine Ltd.",
number = "17",
}