地诺单抗使用说明

Basically all solid tumors may have bone metastasis, such as breast cancer, prostate cancer, lung cancer, thyroid cancer, kidney cancer, gastrointestinal cancer, etc. Cancer cells that have metastasized to the bone can secrete a substance that causes osteoclasts to "eat" bone material. The incidence of bone metastasis in breast cancer and prostate cancer is as high as more than 70%, and data reports on lung cancer vary, with some being as high as 85%. The most commonly used drug for bone metastasis in China is zoledronic acid, and multiple clinical studies have shown that it is significantly more effective than zoledronic acid in patients with bone metastasis from solid tumors.

Instructions for use of denosumab: (1) Denosumab can only be injected subcutaneously, not intravenously, intramuscularly or intradermally. (2) Solid tumor bone metastasis: 120mg once every 4 weeks, injected subcutaneously in the upper arm, thigh or abdomen. (3) Giant cell tumor of bone: 120 mg once every 4 weeks, subcutaneous injection, and then 120 mg on d8 and d15 in the first month of treatment. (4) Administer calcium and vitamin D appropriately to prevent hypocalcemia. (5) Malignant hypercalcemia: 20 mg once every 4 weeks, subcutaneous injection, and then 120 mg on d8 and d15 in the first month of treatment. The medication is injected under the skin in the upper arm, thigh, or abdomen.

During the use of denosumab, patients also need to pay attention to these matters to avoid affecting the efficacy: (1) Do not use the same active drug: patients taking 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: 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: It harms the fetus. Women of childbearing age should be informed of the dangers of this drug and take effective contraceptive measures.