Denosumab: Current Use in the Treatment of Primary Bone Tumors

Savvidou, Olga D.; Bolia, Ioanna K; Chloros, George D.; Papanastasiou, John; Koutsouradis, Panagiotis; Papagelopoulos, Panayiotis J.

doi:10.3928/01477447-20170627-04

Cited by 28 publications

(27 citation statements)

References 64 publications

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“…The pathophysiology of ABC seems to be similar to this [29,36]. Denosumab, which effectively blocks interaction between RANKL and RANK has been approved for the treatment of osteoporosis, metastatic bone disease, multiple myeloma and GCT [19,37]. The use of denosumab as an adjuvant treatment in patients with GCT has shown a high rate of recalcification [38].…”

Section: Discussionmentioning

confidence: 95%

Aneurysmal bone cyst: results of an off label treatment with Denosumab

Dürr¹,

Grahneis²,

Baur‐Melnyk

et al. 2019

BMC Musculoskelet Disord

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Background: The treatment of aneurysmal bone cysts (ABCs) has evolved and less invasive methods have been tried. Denosumab is a monoclonal antibody which inhibits osteoclasts. It has been shown to be effective in giant cell tumour of bone (GCT) of bone and hence promises some effect also in ABC. We report on 6 patients treated with Denosumab and compare our results to the cases already published. Methods: Data of 6 patients with ABCs and patients whose treatment included Denosumab were retrospectively analyzed. Denosumab was used at a dose of 120 mg on days 1, 8, 15 and 29, and every 4 weeks thereafter. In some of these patients the dose was reduced at the end of the treatment. Clinical and radiological responses were evaluated. Results: In 4 female and 2 male patients with a mean age of 17 years (range: 6-30 years) the lesions were located in the sacrum (2), in distal radius, distal femur, talus and pelvis. One of the sacral lesions healed after 12 months and has stayed stable for 3 years since. The second patient received 2 years of therapy with recalcification, but recurred 1 year later and is under renewed therapy. The pelvic lesion improved but recurred. This patient has a 13-years history of intermittent therapy including surgery, two pregnancies and remains in a stable situation. The lesion of the talus did not improve with Denosumab after surgery and was complicated by destruction of the ankle joint with osteoarthritis. Recurrent lesions of the distal femur and the distal radius, previously treated by curettage and bone grafting healed under Denosumab and have remained stable for 2 and 3 years, respectively. One case of severe hypercalcemia was observed in a 7-year old child 6 months after discontinuation of Denosumab. Conclusion: Denosumab provides a treatment option for ABCs in anatomically critical locations. Adjuvant application might reduce the rate of local recurrence. In young patients, severe rebound hypercalcemia months after discontinuation of Denosumab may occur.

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Section: Discussionmentioning

confidence: 95%

Aneurysmal bone cyst: results of an off label treatment with Denosumab

Dürr¹,

Grahneis²,

Baur‐Melnyk

et al. 2019

BMC Musculoskelet Disord

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“…The two most studied drugs have been zoledronic acid and denosumab. 24,25 Zoledronic acid is a nitrogencontaining bisphosphonate which induces apoptosis in osteoclasts through cell membrane disruption by blocking the effect of farnesyl-diphosphate synthase on the mevalonate pathway which is important in cell membrane function. Zoledronic acid use in GCTB has been studied for years and its efficacy appears to occur through the effects on osteoclastrelated damage in GCTB.…”

Section: Medical Treatmentmentioning

confidence: 99%

Giant Cell Tumor of Bone: Review of Current Literature, Evaluation, and Treatment Options

et al. 2018

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Giant cell tumor of bone is a benign albeit aggressive tumor commonly affecting the bones of the knee. Patients with these tumors present with pain, swelling, and inability to bear weight on the involved extremity. These destructive tumors typically arise in the metaphyseal region of the long bones in individuals in the second, third, and fourth generations of life. Histologically, the multinucleated giant cells are the hallmark of the lesion, easily recognized on histological review, which recently have become therapeutic targets for medical management of the disease. For decades, surgical management has been the primary treatment for giant cell tumor of the bone. Some tumors can be treated with excision and filling of the osseous void with bone cement or allograft. This is an effective treatment option with a low to moderate risk of local recurrence while preserving limb function. For more destructive tumors, wide excision and reconstruction with prosthetic, structural allograft or combined allograft prosthetic components are utilized. Advances in medical management of the disease have also demonstrated promise as an effective treatment; however, its use has usually been limited to the treatment of metastatic disease, recurrent disease or when advanced local disease would require surgical treatment felt to be overly morbid.

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“…Denosumab is a human monoclonal antibody which decreases bone resorption by inhibiting osteoclast activation [3]. The current indications for the use of denosumab, as per the National Institute for Health and Care Excellence, include the treatment of osteoporosis in postmenopausal women and in men at increased risk of fractures, the treatment of bone loss associated with hormone ablation in men with prostate cancer at increased risk of fractures, the prevention of skeletal related events in patients with bone metastases from solid tumours and the treatment of giant cell tumour of bone that is unresectable or where surgical resection is likely to result in severe morbidity in adults and skeletally mature adolescents [4].…”

Section: склеротические изменения метафизов костей при лечении деносуmentioning

confidence: 99%

“…As aneurysmal bone cysts express osteoclastic markers, therapies which inhibit osteoclastic activity such as denosumab have begun to be used in their treatment. However, further research into the use of denosumab in patients with aneurysmal bone cysts is required [3].…”

Section: склеротические изменения метафизов костей при лечении деносуmentioning

confidence: 99%