What are the guideline sources, guidelines and references for Hypercalcemia of malignancy ?
Guideline sources The following summarized guidelines for the evaluation and management of hypercalcemia of malignancy (HCM) are prepared by our editorial team based on guidelines from the Endocrine Society (ES 2022). 1 Calculator Calculator Eastern Cooperative Oncology G Karnofsky performance status s Guidelines 1. Diagnostic investigations Assessment of renal function: assess renal function (CrCl or estimated GFR) before administering IV bisphosphonates in adult patients with HCM. E 2. Medical management Antiresorptive therapies: https://web.pathway.md/diseases/recqRDcPcXPh2eIXa 1/2 6/24/23, 12:44 PM Hypercalcemia of malignancy Pathway Initiate treatment with an IV bisphosphonate or denosumab in adult patients with HCM. B Consider preferring denosumab over intravenous bisphosphonates. B Consider initiating a combination of calcitonin and an IV bisphosphonate or denosumab as initial therapy in adult patients with severe HCM (serum calcium > 14 mg/dL; 3.5 mmol/L). C Intravenous fluids: provide adequate hydration with IV fluids as first-line therapy in adults with HCM while awaiting the effect of antiresorptive drugs. Tailor therapy according to cardiac function. E 3. Specific circumstances Patients with renal insufficiency: administer renal dosing of zoledronic acid over 30-60 minutes or renal dosing of pamidronate over 2-24 hours in adult patients with HCM and renal insufficiency (defined as CrCl < 60 mL/min) treated with IV bisphosphonates. E Patients with calcitriol-secreting tumor: consider administering an IV bisphosphonate or denosumab in adult patients with HCM from tumors associated with high calcitriol levels, such as lymphomas, already receiving corticosteroid therapy but continuing to have severe or symptomatic hypercalcemia. C Patients with parathyroid carcinoma: consider administering a calcimimetic, an IV bisphosphonate, or denosumab in adult patients with hypercalcemia due to parathyroid carcinoma. C Show 3 more 4. Follow-up and surveillance Serial clinical and laboratory assessment: monitor dental hygiene and oral health, including visual examination of the mouth, in the context of the provision of antiresorptive therapy in adult patients with HCM. E Show 2 more Management of refractory/recurrent hypercalcemia: consider administering denosumab in adult patients with refractory/recurrent HCM on IV bisphosphonate therapy. C References 1. Ghada El-Hajj Fuleihan, Gregory A Clines, Mimi I Hu et al. Treatment of Hypercalcemia of Malignancy in Adults: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2022 Dec 21:dgac621. Open https://web.pathway.md/diseases/recqRDcPcXPh2eIXa 2/2