{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T22:38:05Z","timestamp":1765233485339,"version":"build-2065373602"},"reference-count":141,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2023,1,15]],"date-time":"2023-01-15T00:00:00Z","timestamp":1673740800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>The medical therapy of advanced renal cell carcinoma (RCC) is based on the use of targeted therapies, such as tyrosine kinase inhibitors (TKI) and immune-checkpoint inhibitors (ICI). These therapies are characterized by multiple endocrine adverse events, but the effect on the bone is still less known. Relatively few case reports or small case series have been specifically focused on TKI and ICI effects on bone metabolism. However, the importance to consider these possible side effects is easily intuitable because the bone is one of the most frequent metastatic sites of RCC. Among TKI used in RCC, sunitinib and sorafenib can cause hypophosphatemia with increased PTH levels and low-normal serum calcium levels. Considering ICI, nivolumab and ipilimumab, which can be used in association in a combination strategy, are associated with an increased risk of hypocalcemia, mediated by an autoimmune mechanism targeted on the calcium-sensing receptor. A fearsome complication, reported for TKI and rarely for ICI, is osteonecrosis of the jaw. Awareness of these possible side effects makes a clinical evaluation of RCC patients on anticancer therapy mandatory, especially if associated with antiresorptive therapy such as bisphosphonates and denosumab, which can further increase the risk of these complications.<\/jats:p>","DOI":"10.3390\/cancers15020529","type":"journal-article","created":{"date-parts":[[2023,1,16]],"date-time":"2023-01-16T04:31:32Z","timestamp":1673843492000},"page":"529","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Bone Metabolism Effects of Medical Therapy in Advanced Renal Cell Carcinoma"],"prefix":"10.3390","volume":"15","author":[{"given":"Rosa Maria","family":"Paragliola","sequence":"first","affiliation":[{"name":"Department of Translational Medicine and Surgery, Unit of Endocrinology, Universit\u00e0 Cattolica del Sacro Cuore\u2014Fondazione Policlinico \u201cGemelli\u201d IRCCS, Largo Gemelli 8, I-00168 Rome, Italy"},{"name":"Unicamillus, Saint Camillus International University of Medical Sciences, via di S. Alessandro 10, I-00131 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5828-4438","authenticated-orcid":false,"given":"Francesco","family":"Torino","sequence":"additional","affiliation":[{"name":"Department of Systems Medicine, Medical Oncology Unit, University of Rome Tor Vergata, via Montpellier 1, I-00133 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agnese","family":"Barnabei","sequence":"additional","affiliation":[{"name":"Endocrinology Unit, P.O.-S. Spirito in Sassia, ASL Roma 1, Lungotevere in Sassia 1, I-00193 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4161-6250","authenticated-orcid":false,"given":"Giovanni Maria","family":"Iannantuono","sequence":"additional","affiliation":[{"name":"Department of Systems Medicine, Medical Oncology Unit, University of Rome Tor Vergata, via Montpellier 1, I-00133 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8167-4338","authenticated-orcid":false,"given":"Andrea","family":"Corsello","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine and Surgery, Unit of Endocrinology, Universit\u00e0 Cattolica del Sacro Cuore\u2014Fondazione Policlinico \u201cGemelli\u201d IRCCS, Largo Gemelli 8, I-00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4772-1417","authenticated-orcid":false,"given":"Pietro","family":"Locantore","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine and Surgery, Unit of Endocrinology, Universit\u00e0 Cattolica del Sacro Cuore\u2014Fondazione Policlinico \u201cGemelli\u201d IRCCS, Largo Gemelli 8, I-00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salvatore Maria","family":"Corsello","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine and Surgery, Unit of Endocrinology, Universit\u00e0 Cattolica del Sacro Cuore\u2014Fondazione Policlinico \u201cGemelli\u201d IRCCS, Largo Gemelli 8, I-00168 Rome, Italy"},{"name":"Unicamillus, Saint Camillus International University of Medical Sciences, via di S. 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