Denosumab for Effective Tumor Size Reduction in Patients With Giant Cell Tumors of the Bone: A Systematic Review and Meta-Analysis

Abstract

Background: Denosumab is a human monoclonal antibody that has been used successfully in the treatment of giant cell tumors of bone. These tumors are rare and, in principle, benign, but they are highly aggressive, locally advanced, osteolytic bone tumors that can metastasize to the lungs. Denosumab is an effective treatment when these tumors cannot be surgically removed or when surgical resection is likely to lead to severe morbidity (eg, loss of limbs or joints). The aim of this systematic review and meta-analysis was to investigate patients with giant cell tumors of bone who experienced tumor progression during treatment with denosumab and to compare them with patients who experienced reduction of their giant cell tumors of bone during treatment with denosumab. Methods: Embase, Cochrane Library, and MEDLINE/PubMed databases were searched for trials submitted by January 7, 2020, that reported the efficacy and safety of denosumab in patients with giant cell tumors of bone. Results: Sixty studies were reviewed, involving a total of 1074 patients who had giant cell tumors of bone and were treated with denosumab. Of the 60 studies, 58% of the patients were from case series studies, 39% from open-label phase II studies, and 3% from case reports. The response rate for denosumab as a treatment for giant cell tumors of bone was 97.5%, with statistical significance ( P < .0001). Pain in the limbs was statistically the most common adverse event for denosumab treatment in case series studies ( P < .0001). No treatment-related deaths occurred in the reviewed studies. Conclusion: Cumulative evidence supports the addition of surgery to optimal medical therapy with denosumab to reduce tumor size, clinical symptoms, and mortality among patients with giant cell tumors of bone.

A Rationale for the Activity of Bone Target Therapy and Tyrosine Kinase Inhibitor Combination in Giant Cell Tumor of Bone and Desmoplastic Fibroma: Translational Evidences

“…Taken together, our results are consistent with the clinical observation that denosumab is effective in GCTB [ 49 , 50 ]. Moreover, our results are suggestive of a promising role of Lenvatinib, in monoregimen or in combination, for the management of GCTB and DF, providing some evidence for better exploring the use of these drugs in these poorly understood diseases.…”

Three-dimensional printed talar prosthesis with biological function for giant cell tumor of the talus: A case report and review of the literature

“…Giant cell tumors (GCTs), also called osteoclastomas, account for approximately 5% of bone tumors and 20% of benign bone tumors[ 3 , 4 ]. The highest incidence rate of GCTs occurs between the ages of 20 and 40 years with a peak at the age of 30.…”

Treatment of locally aggressive benign bone tumors by means of extended intralesional curettage without chemical adjuvants

“…loss of limbs or joints). 8 , 9 In the literature, there have been studies of patients with GCT who were treated with different chemical adjuvants. In most of these studies, recurrence rates ranged from 10% to 20%.…”