Title
Treatment of Hypercalcemia of Malignancy in Adults
Authoring Organization
Publication Month/Year
December 20, 2022
Last Updated Month/Year
October 23, 2024
Supplemental Implementation Tools
Document Type
Guideline
Country of Publication
US
Document Objectives
Hypercalcemia of malignancy (HCM) is the most common metabolic complication of malignancies, but its incidence may be declining due to potent chemotherapeutic agents. The high mortality associated with HCM has declined markedly due to the introduction of increasingly effective chemotherapeutic drugs. Despite the widespread availability of efficacious medications to treat HCM, evidence-based recommendations to manage this debilitating condition are lacking.
Target Patient Population
Adults with hypercalcemia of malignancy (HCM)
PICO Questions
Should a bisphosphonate or denosumab vs no treatment with a bisphosphonate or denosumab be used for adults with hypercalcemia of malignancy?
Should denosumab vs a bisphosphonate be used for adults with hypercalcemia of malignancy?
Should addition of calcitonin vs no calcitonin be used for adults with severe hypercalcemia of malignancy who will be started on a bisphosphonate or denosumab?
Should a bisphosphonate or denosumab vs no bisphosphonate or denosumab be used for adults with hypercalcemia resulting from tumors associated with high calcitriol levels who are already treated with a glucocorticoid?
Should denosumab vs no denosumab be used for adults with refractory/recurrent hypercalcemia of malignancy on a bisphosphonate?
Should a calcimimetic vs a bisphosphonate or denosumab be used for adults with hypercalcemia due to parathyroid carcinoma?
Should addition of a bisphosphonate or denosumab vs no addition of a bisphosphonate or denosumab be used for adults with hypercalcemia due to parathyroid carcinoma in patients not adequately controlled with a calcimimetic?
Should a calcimimetic vs no calcimimetic be used for adults with hypercalcemia due to parathyroid carcinoma who are not adequately controlled with a bisphosphonate or denosumab?
Inclusion Criteria
Male, Female, Adult, Older adult
Health Care Settings
Ambulatory, Emergency care, Hospital, Outpatient
Intended Users
Nurse, nurse practitioner, physician, physician assistant
Scope
Counseling, Assessment and screening, Treatment
Diseases/Conditions (MeSH)
D008223 - Lymphoma, D006934 - Hypercalcemia, D010282 - Parathyroid Neoplasms
Keywords
denosumab, bisphosphonate, Hypercalcemia of malignancy, high calcitriol levels, lymphoma, calcimimetic, parathyroid carcinoma
Source Citation
El-Hajj Fuleihan G, Clines GA, Hu MI, et al. Treatment of Hypercalcemia of Malignancy in Adults: An Endocrine Society Clinical Practice Guideline, J Clin Endocrinol Metab. 2022, 103(8)