Thoracic Oncology

 RET Inhibitors and Risk of ONJ

Stefanie Houseknecht's profile image
Stefanie Houseknecht posted 10-14-2025 11:00 AM

Hello Thoracic Team,

Do you hold RET inhibitors (given their off-target VEGFR1 and VEGFR3 inhibition) for patients requiring dental surgery with manipulation around the jaw bone or only if on concurrent antiresorptive therapy with bisphosphonates or denosumab?

I am seeing a low risk of ONJ in the literature from VEGF inhibition alone (< 1%) so thinking it may be okay to proceed as long as the procedure is not an extraction but looking for any additional experience or insight before I reply to my patient.

Thanks!

Stefanie Houseknecht, PharmD, BCOP

Clinical Pharmacy Specialist, Thoracic Malignancies

Johns Hopkins Hospital and Bayview Medical Center

ph: 443-401-3258