{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T09:04:20Z","timestamp":1762506260980,"version":"3.44.0"},"reference-count":17,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"abstract":"<jats:p>Denosumab, a fully humanised monoclonal antibody, is licensed for treatment of postmenopausal osteoporosis, hormone ablation-induced bone loss and for prevention of skeleton-related events in patients with bone metastases from solid tumours. In pivotal phase 3 randomised trials, denosumab caused profound hypocalcaemia in patients with normocalcaemia despite oral calcium and vitamin D supplementation. This significant hypocalcaemic effect can be exploited to treat hypercalcaemia of malignancy (HCM). Recent reports from the USA suggest that denosumab is an effective treatment of HCM. According to our knowledge, we report the first two cases in UK with bisphosphonate refractory hypercalcaemia who responded to denosumab injections. Our first case gained 7\u2005months of stabilisation of hypercalcaemia following prolonged admissions with life-threatening levels, while our second case achieved rapid normalisation of serum calcium levels for the first time in 14\u2005months. We conclude that denosumab should be the treatment of choice for patients with bisphosphonate refractory hypercalcaemia.<\/jats:p>","DOI":"10.1136\/bcr-2013-202861","type":"journal-article","created":{"date-parts":[[2014,1,30]],"date-time":"2014-01-30T05:28:41Z","timestamp":1391059721000},"page":"bcr2013202861","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":16,"title":["Denosumab should be the treatment of choice for bisphosphonate refractory hypercalcaemia of malignancy"],"prefix":"10.1136","volume":"2014","author":[{"given":"Jason","family":"Adhikaree","sequence":"first","affiliation":[{"name":"Department of Oncology, Nottingham City Hospital, Nottingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yvette","family":"Newby","sequence":"additional","affiliation":[{"name":"Department of Oncology, Nottingham City Hospital, Nottingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Santhanam","family":"Sundar","sequence":"additional","affiliation":[{"name":"Department of Oncology, Nottingham City Hospital, Nottingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2014,1,30]]},"reference":[{"key":"2025082803415124000_2014.jan30_1.bcr2013202861.1","unstructured":"National Cancer Institute: PDQ Hypercalcemia. Bethesda, MD: National Cancer Institute. Date last modified 01\/09\/2013. [Internet]. [cited 28 Oct 2013]. http:\/\/www.cancer.gov\/cancertopics\/pdq\/supportivecare\/hypercalcemia\/HealthProfessional"},{"key":"2025082803415124000_2014.jan30_1.bcr2013202861.2","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1200\/JCO.2001.19.2.558","article-title":"Zoledronic acid is superior to pamidronate in the treatment of hypercalcemia of malignancy: a pooled analysis of two randomized, controlled clinical trials","volume":"19","author":"Major","year":"2001","journal-title":"J Clin Oncol"},{"key":"2025082803415124000_2014.jan30_1.bcr2013202861.3","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2010-0154"},{"key":"2025082803415124000_2014.jan30_1.bcr2013202861.4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0809003"},{"key":"2025082803415124000_2014.jan30_1.bcr2013202861.5","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0809493"},{"key":"2025082803415124000_2014.jan30_1.bcr2013202861.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2012.08.002"},{"key":"2025082803415124000_2014.jan30_1.bcr2013202861.7","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2012.41.7923"},{"key":"2025082803415124000_2014.jan30_1.bcr2013202861.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.clgc.2013.06.002"},{"key":"2025082803415124000_2014.jan30_1.bcr2013202861.9","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djt225"},{"key":"2025082803415124000_2014.jan30_1.bcr2013202861.10","unstructured":"National Institute for Health and Care Excellence (NICE). Bone metastases from solid tumours\u2014denosumab. Technology appraisals TA265 Issued: October 2012."},{"key":"2025082803415124000_2014.jan30_1.bcr2013202861.11","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2010.29.7101"},{"key":"2025082803415124000_2014.jan30_1.bcr2013202861.12","doi-asserted-by":"publisher","DOI":"10.1007\/s10585-007-9127-1"},{"key":"2025082803415124000_2014.jan30_1.bcr2013202861.13","doi-asserted-by":"publisher","DOI":"10.1016\/j.cellsig.2009.02.012"},{"key":"2025082803415124000_2014.jan30_1.bcr2013202861.14","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)62344-6"},{"key":"2025082803415124000_2014.jan30_1.bcr2013202861.15","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2010.31.3304"},{"key":"2025082803415124000_2014.jan30_1.bcr2013202861.16","doi-asserted-by":"publisher","DOI":"10.1007\/s12032-009-9327-4"},{"key":"2025082803415124000_2014.jan30_1.bcr2013202861.17","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-156-12-201206190-00026"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2013-202861","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T10:41:58Z","timestamp":1756377718000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2013-202861"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,1,30]]},"references-count":17,"alternative-id":["10.1136\/bcr-2013-202861"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2013-202861","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2014,1,30]]}}}