Hypercalcemia of Malignancy Clinical Practice Guidelines (ES, 2023)

Endocrine Society

These are some of the highlights of the guidelines without analysis or commentary. For more information, go directly to the guidelines by clicking the link in the reference.

March 01, 2023

Clinical guidelines on the management of adults with hypercalcemia of malignancy (HCM) were published in January 2023 by the Endocrine Society, in JAMA Oncology.[1]

Recommended treatment for adults with HCM is intravenous (IV) hydration and IV bisphosphonate (BP) or denosumab (Dmab). For acute HCM, Dmab treatment versus management with IV BP is suggested.

Suggested treatment for adults with severe HCM (serum calcium level >14 mg/dL) is combination therapy with calcitonin and an IV BP or Dmab.

If HCM treated with IV BP proves to be refractory or recurrent, Dmab therapy is suggested.

It is suggested that IV BP or Dmab be added to the treatment of hypercalcemia resulting from high calcitriol levels, in patients experiencing symptomatic or severe hypercalcemia despite glucocorticoid therapy.

Calcimimetic and/or antiresorptive therapy can be used in HCM caused by parathyroid carcinoma, depending on the HCM's severity and the initial treatment's outcome.

For more information, please go to Hypercalcemia and Parathyroid Carcinoma.


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