- 期刊
Denosumab for Breast Cancer with Bone Metastases-Induced Hypercalcemia Complicated with Acute Renal Failure
以Denosumab治療骨轉移乳癌患者合併腎衰竭之高血鈣
摘要
癌症相關高血鈣在乳癌合併骨轉移患者是個比較常見的併發症，嚴重者可能導致腎衰竭及意識昏迷。治療的黃金準則為充足水份補充、靜脈注射雙磷酸鹽藥物以及在確定低血容已矯正恢復後可以給予亨利氏環利尿劑。雙磷酸鹽藥物因有使腎功能變差之可能性，是否可用來治療癌症相關高血鈣併發嚴重腎功能損傷之患者，仍有爭議。細胞核因子KappaB受體活化因子之配體（RANK-L）是促使蝕骨細胞分化、具有活性以及存活的一個必需訊息傳遞訊號。Denosumab為一全人類成份的抗體，可以中和掉RANK-L而使骨頭表面的蝕骨細胞喪失，進而抑制骨頭的再吸收。我們在此報告一個以denosumab治療乳癌相關高血鈣併發腎衰竭成功的患者。
並列摘要
Cancer-related hypercalcemia is a relative common complication from breast cancer with bone metastasis and may cause renal failure and coma in severe condition. The cornerstone of treatment is vigorous hydration, intravenous bisphosphonates, and loop diuretic agent only after corrected hypovolemia. Bisphosphonates is related deterioration of renal function and is controversial when administered in cancer-related hypercalcemia complicated markedly renal deterioration. The receptor activator of nuclear factor-kappa Bligand (RANK-L) is an essential signal to stimulate differentiation, activity and survival of osteoclast. Denosumab, a fully human antibody which neutrolizes RANK-L leading to the loss of osteoclasts from bone surface and inhibition of bone resorption. Here, we present a case report of breast cancer-related hypercalcemia complicated renal failure was successfully treated by denosumab.