Severe Hypocalcemia Associated With Denosumab in Metastatic Castration-Resistant Prostate Cancer: Risk Factors and Precautions for Treating Physicians

Agents that delay or prevent skeletal complications in metastatic castration-resistant prostate cancer (mCRPC) are valuable treatments in this bone tropic malignancy. Denosumab, a fully human monoclonal antibody against RANKL (receptor activator of nuclear factor κ B ligand) a driver of osteoclast formation, function, and survival, inhibits osteoclast-mediated bone destruction. Treatment with denosumab delays the time to skeletal-related events (SREs) such as pathologic fracture or the need for radiotherapy or surgery to bone and decreases the incidence of SREs.