Pembrolizumab related osteonecrosis of the jaw

Area of Science:

• Oncology
• Immunology
• Oral and Maxillofacial Surgery

Background:

• Medication-related osteonecrosis of the jaw (MRONJ) is a recognized adverse effect associated with certain medications.
• Immune checkpoint inhibitors (ICIs) like pembrolizumab are increasingly used in cancer therapy.
• The potential for ICIs to cause MRONJ is an emerging concern.

Observation:

• This case report presents a patient who developed MRONJ.
• The patient was undergoing treatment with pembrolizumab for an unspecified condition.
• The clinical presentation and diagnostic findings of MRONJ were consistent with established criteria.

Findings:

• Pembrolizumab, an immune checkpoint inhibitor, was identified as the causative agent for Medication-related osteonecrosis of the jaw.
• This represents a novel association between this class of immunotherapy and MRONJ.
• The case highlights the need for vigilance regarding oral side effects in patients receiving pembrolizumab.

Implications:

• The findings suggest that pembrolizumab may pose a risk for developing MRONJ.
• Clinicians should consider MRONJ in patients on pembrolizumab presenting with relevant oral symptoms.
• Further research is warranted to understand the mechanism and incidence of MRONJ with ICIs.