Denosumab for Breast Cancer with Bone Metastases-Induced Hypercalcemia Complicated with Acute Renal Failure

Cancer-related hypercalcemia is a relative common complication from breast cancer with bone metastasis and may cause renal failure and coma in severe condition. The cornerstone of treatment is vigorous hydration, intravenous bisphosphonates, and loop diuretic agent only after corrected hypovolemia. Bisphosphonates is related deterioration of renal function and is controversial when administered in cancer-related hypercalcemia complicated markedly renal deterioration. The receptor activator of nuclear factor-kappa Bligand (RANK-L) is an essential signal to stimulate differentiation, activity and survival of osteoclast. Denosumab, a fully human antibody which neutrolizes RANK-L leading to the loss of osteoclasts from bone surface and inhibition of bone resorption. Here, we present a case report of breast cancer-related hypercalcemia complicated renal failure was successfully treated by denosumab.