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How safe and effective is denosumab for bone giant cell tumour?

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Abstract

Recent clinical studies have suggested that denosumab is associated with beneficial tumour response, surgical down-staging, and reduced surgical morbidity in patients with giant cell tumour of bone. However, these studies reported results of patients still on denosumab treatment, or patients after denosumab treatment but with a short follow-up. Other studies reported that the new osseous tumour matrix and thickened cortical bone that develop with denosumab treatment does not allow the surgeon to delineate the true extent of the tumour, and probably increases the risk for local recurrence. A study showed that cell proliferation is only diminished by denosumab; the cells continue to proliferate in vitro, albeit at a slower rate. More importantly, nine cases of malignant transformation of GCT during denosumab therapy without previous radiation exposure have been reported; inhibition of RANKL may increase the risk of new malignancies due to immunosuppression. With these concerns in mind, this article is an attempt to put essential information in one place, creating a comprehensive review that the curious reader would find interesting and informative.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Istituto Ortopedico Rizzoli, Bologna, Italy

    Costantino Errani

  2. Department of Orthopaedic Surgery, Nara Medical University, Nara, Japan

    Shinji Tsukamoto

  3. First Department of Orthopaedic Surgery, School of Medicine, National and Kapodistrian University of Athens, 41 Ventouri Street, 15562, Holargos, Athens, Greece

    Andreas F. Mavrogenis

Authors
  1. Costantino Errani
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  2. Shinji Tsukamoto
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  3. Andreas F. Mavrogenis
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Correspondence to Costantino Errani or Andreas F. Mavrogenis.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Errani, C., Tsukamoto, S. & Mavrogenis, A.F. How safe and effective is denosumab for bone giant cell tumour?. International Orthopaedics (SICOT) 41, 2397–2400 (2017). https://doi.org/10.1007/s00264-017-3536-9

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  • DOI: https://doi.org/10.1007/s00264-017-3536-9

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