Hypocalcemia in patients with metastatic bone disease treated with denosumab

Bone stands out as the most frequently affected distant site for metastatic disease, leading to significant patient morbidity, loss of autonomy, decrease in quality of life and increased societal costs. Frequent consequences of metastatic bone disease include pain, hypercalcemia, pathologic fracture, and myeloid compression, collectively referred as skeletal related events (SRE). Bone targeted agents (BTA), such as zoledronic acid (ZA) and denosumab, changed significantly this panorama by delaying time to first and subsequent SRE.