Sensipar® for Parathyroid Carcinoma

Sensipar® is indicated for the treatment of hypercalcemia in patients with parathyroid carcinoma

Sensipar®: an effective therapeutic option for treating hypercalcemia in patients with parathyroid carcinoma¹

Parathyroid carcinoma is a rare malignancy of the parathyroid gland that causes excess secretion of parathyroid hormone (PTH) by the functioning tumor.² Excess secretion of PTH can lead to hypercalcemia as well as renal and skeletal complications such as nephrolithiasis, nephrocalcinosis, renal insufficiency, fractures, and osteoporosis.^2,3

Unfortunately, medical management with current therapies can be challenging:

The cancer is commonly resistant to chemotherapy and radiotherapy²
Although parathyroidectomy can be curative, local seeding of cancer in the neck and metastases are common³
Due to the size and location of the parathyroid glands as well as the technical nature of the surgical procedure, parathyroidectomy is not always successful⁴

Sensipar® is an approved medical therapy for the treatment of hypercalcemia in patients with parathyroid carcinoma.⁵

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Improving Care for Patients
Monitoring and Titration Are Key
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Important Safety Information

Sensipar® treatment should not be initiated if serum calcium is less than the lower limit of the normal range (8.4 mg/dL).

Sensipar® lowers serum calcium; therefore, it is important that patients are carefully monitored for the occurrence of hypocalcemia.

Significant reductions in calcium may lower the threshold for seizures. Secondary hyperparathyroidism (HPT) patients, particularly those with a history of seizure disorder, should be carefully monitored for the occurrence of low serum calcium or symptoms of hypocalcemia.

In Sensipar® postmarketing use, isolated, idiosyncratic cases of hypotension, worsening heart failure, and/or arrhythmia were reported in patients with impaired cardiac function. The causal relationship to Sensipar® therapy could not be completely excluded and may be mediated by reductions in serum calcium levels.

Adynamic bone disease may develop if intact parathyroid hormone (iPTH) levels are suppressed below 100 pg/mL.

Patients with moderate to severe hepatic impairment should be monitored throughout treatment with Sensipar®, as cinacalcet exposure assessed by area under the curve (AUC) was higher than in patients with normal hepatic function.

Serum calcium and serum phosphorus should be measured within 1 week and PTH should be measured 1 to 4 weeks after initiation or dose adjustment of Sensipar®. Once the maintenance dose has been established, serum calcium and serum phosphorus should be measured approximately monthly, and PTH every 1 to 3 months.

The most commonly reported side effects were nausea, vomiting, and diarrhea.

References

Silverberg SJ, Rubin MR, Faiman C, et al. Cinacalcet hydrochloride reduces the serum calcium concentration in inoperable parathyroid carcinoma. J Clin Endocrinol Metab. 2007;92:3803-3808.
Shane E. Clinical review 122: parathyroid carcinoma. J Clin Endocrinol Metab. 2001;86:485-493.
Silverberg SJ, Faiman C, Bilezikian JP, et al. Cinacalcet HCl effectively treats hypercalcemia in patients with parathyroid carcinoma. J Bone Miner Res. 2004;19:S186. Abstract SA495 and poster.
Silverberg SJ, Bilezikian JP, Bone HG, Talpos GB, Horwitz MJ, Stewart AF. Therapeutic controversies in primary hyperparathyroidism. J Clin Endorinol Metab. 1999;84:2275-2285.
Sensipar® (cinacalcet HCl) prescribing information, Amgen.

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Sensipar® for Parathyroid Carcinoma

Sensipar® is indicated for the treatment of hypercalcemia in patients with parathyroid carcinoma

Sensipar®: an effective therapeutic option for treating hypercalcemia in patients with parathyroid carcinoma1

Important Safety Information

References

Sensipar®: an effective therapeutic option for treating hypercalcemia in patients with parathyroid carcinoma¹