RT Journal Article SR Electronic T1 Denosumab-induced hypocalcaemia in metastatic gastric cancer JF BMJ Supportive & Palliative Care JO BMJ Support Palliat Care FD British Medical Journal Publishing Group SP bmjspcare-2020-002548 DO 10.1136/bmjspcare-2020-002548 A1 Craig Gouldthorpe A1 Richard Quinton A1 Donna Wakefield YR 2020 UL http://spcare.bmj.com/content/early/2020/08/27/bmjspcare-2020-002548.abstract AB Hypocalcaemia in malignancy is infrequently reported and the underlying cause is often multifactorial. Denosumab, an antiresorptive medication, can be used to treat a number of cancer-related complications including hypercalcaemia, metastatic bone pain and to reduce fracture-events. We present a case of a hospice inpatient with profound and recurring hypocalcaemia following a single denosumab infusion which required repeated hospitalisation, for intravenous calcium, alongside a prolonged course of vitamin D and electrolyte replacement. The case highlights the risk of hypocalcaemia with denosumab use, together with the need to identify and treat vitamin D deficiency in both the prevention and management of such a complication.