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Updated: Oct 13, 2025

Models of Bone Metastasis
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Hypercalcemia of Malignancy.

Mimi I Hu1

  • 1Department of Endocrine Neoplasia & Hormonal Disorders, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1461, Houston, TX 77030, USA.

Endocrinology and Metabolism Clinics of North America
|November 14, 2021
PubMed
Summary
This summary is machine-generated.

Hypercalcemia of malignancy (HCM) is a serious cancer complication. While hydration and bone-modifying agents help manage acute symptoms, new treatments are needed for patients resistant to current therapies.

Keywords:
Antiresorptive therapyCancerEtiologyEvaluationHypercalcemiaRefractory

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Area of Science:

  • Oncology
  • Endocrinology
  • Pharmacology

Background:

  • Hypercalcemia of malignancy (HCM) is a critical oncologic emergency.
  • It presents with substantial symptom burden, comorbidities, and increased mortality.
  • Pathologically, HCM often involves increased osteoclast-mediated bone resorption.

Purpose of the Study:

  • To review current management strategies for acute and symptomatic hypercalcemia of malignancy.
  • To highlight the role of hydration and antiresorptive bone-modifying agents.
  • To identify the need for novel therapeutic agents in refractory HCM cases.

Main Methods:

  • Review of existing literature on hypercalcemia of malignancy management.
  • Analysis of the efficacy of current antiresorptive therapies, including bisphosphonates and denosumab.
  • Discussion of pathological mechanisms driving HCM.

Main Results:

  • Most patients with HCM respond to available antiresorptive therapies.
  • Hydration and bone-modifying agents are key temporizing management strategies.
  • A subset of patients demonstrates refractoriness to bisphosphonates and denosumab.

Conclusions:

  • Effective long-term control of HCM relies on managing the underlying malignancy.
  • Current temporizing strategies are effective for many, but not all, patients.
  • Further research into alternative agents is crucial for patients refractory to bisphosphonates and denosumab.