Xgeva要注意哪些事项？

Denosumab, a monoclonal antibody targeting RANKL, can reduce bone-related events related to bone lesions or metastases in patients with advanced solid tumors, and its anti-bone metastasis effect is significantly better than traditional bisphosphonate drugs. The drug has been approved by the US FDA for the prevention and treatment of bone metastasis in solid tumors, and has also been included in the NCCN guidelines. Clinical data showed that compared with zoledronic acid, Xgeva denosumab prolonged the time to the first adverse bone event (ARE) in patients by 17%, or significantly delayed the median time to the first bone-related event (SRE) by 8.2 months (27.6 months vs. 19.4 months). months), denosumab also prolonged the time from first episode to recurrence of SRE by 18% in the study; in addition, for patients with mild or no pain at study enrollment, Xgeva denosumab also significantly prolonged the time to worsening pain compared with zoledronic acid.

Xgeva denosumab is so effective, what should patients pay attention to when using it?

(1) Do not use the same active drug: Patients taking Xgeva denosumab should not use denosumab. (2) Allergic reactions may occur when using denosumab; if allergic reactions occur, the medication should be discontinued permanently. (3) Hypocalcemia: Xgeva denosumab may cause severe symptoms of hypocalcemia, or be fatal. Hypocalcemia should be corrected before medication, and the patient's blood calcium level should be monitored during treatment, especially in the first week of first medication, and calcium and vitamin D should be supplemented appropriately.

(4) Osteonecrosis of the jaw (ONJ): Osteonecrosis of the jaw (ONJ) has been reported. Oral examination should be performed before medication, symptoms should be observed during treatment, and any invasive dental procedures should be avoided. (5) Atypical femoral fracture: Assess the patient’s thigh or groin pain to diagnose atypical femoral fracture. (6) Hypercalcemia after discontinuation of medication: Monitor patient’s symptoms and treat appropriately. (7) Embryo-fetal toxicity: Denosumab harms the fetus. Women of childbearing age should be informed of the dangers of this drug and take effective contraceptive measures.