Giant cell tumor of bone following denosumab treatment: assessment of tumor response using various imaging modalities

Alothman, Maram; Althobaity, Waleed; Asiri, Yasser; Alreshoodi, Saleh; Al‐Ismail, Khalid; Alshaalan, Meshal

doi:10.1186/s13244-020-00845-y

Cited by 8 publications

(8 citation statements)

References 17 publications

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“…This finding could be further supported by the reduction of SUVmax in PET/CT after denosumab treatment (Figure 1D), which was also attributed to the elimination of the giant cells 8,25,30,31 . X-ray and CT examinations were used to evaluate the development of new ossification as well as increased cortical thickness 4,12,14,15,19,29,32,33 . In this study, we observed new ossification and reappearance of cortical integrity around the soft-tissue mass in both ultra-short group (15.6% and 12.5%) and conventional group (65.2% and 56.5%), with higher frequency in the latter group (Figure 3A–C).…”

Section: Discussionsupporting

confidence: 62%

“…8,25,30,31 X-ray and CT examinations were used to evaluate the development of new ossification as well as increased cortical thickness. 4,12,14,15,19,29,32,33 In this study, we observed new ossification and reappearance of cortical integrity around the soft-tissue mass in both ultra-short group (15.6% and 12.5%) and conventional group (65.2% and 56.5%), with higher frequency in the latter group (Figure 3A-C). This result was in accord with the histological finding that more cases (92%) in the conventional group showed new bone formation than those in the ultra-short group (68.3%).…”

Section: Radiological and Histological Response Induced By Ultra-shor...supporting

confidence: 51%

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Ultra-Short Course of Neo-Adjuvant Denosumab for Nerve-Sparing Surgery for Giant Cell Tumor of Bone in Sacrum

Liang

Liu

Yang

et al. 2021

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Study Deign. This was a retrospective study about sacral giant cell tumor of bone (GCTB).Objective. This study aimed to investigate whether ultra-short course of neo-adjuvant denosumab treatment for sacral GCTB could (1) induce radiological and histological response? (2) Facilitate nerve-sparing surgery? (3) Achieve satisfactory oncological and functional outcomes? Summary of Background Data. Previous reports on long course of neo-adjuvant denosumab treatment for GCTB showed significant tumor response and a relatively high recurrent rate after curettage. Methods. Sixty-six patients with sacral GCTB treated with neoadjuvant denosumab and nerve-sparing surgery were categorized into ultra-short course group ( 3 doses and operation within D21 since 1st dose, 41 patients) or conventional group (>3 doses or operation after D21 since 1st dose, 25 patients). The radiological and histological response, operative data, oncological and functional outcomes were compared. Results. The ultra-short course group demonstrated fewer doses of neo-adjuvant denosumab (mean: 2.1 vs. 4.8, P < 0.001) and shorter time to surgery (12.2 days vs. 72.3days, P < 0.001). Similar patterns of radiological and histological response were observed in the two groups with less fibrosis and ossification in the ultra-short course group. The operative duration (199.9 min vs. 187.8 min, P ¼ 0.364) and estimated blood loss (1552.4 mL vs. 1474.0 mL, P ¼ 0.740) were comparable. Most (94.8%) of the patients received adjuvant denosumab. After a mean follow-up of 29.4 months, three cases (8.8%) and five cases (20.8%) showed local recurrence in each group (P ¼ 0.255). The estimated recurrence-free survival (56.2 vs. 51.2 months, P ¼ 0.210) and the functional status [Motor-Urination-Defecation scores: 25.9 vs. 25.7, P ¼ 0.762] did not differ between the two groups. Conclusion. Ultra-short course of neo-adjuvant denosumab for sacral GCTB could elicit radiological and histological responses as conventional course did. The less degree of fibrosis and ossification might facilitate nerve-sparing surgery and help to achieve satisfactory local control and functional status.

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Section: Discussionsupporting

confidence: 62%

Section: Radiological and Histological Response Induced By Ultra-shor...supporting

confidence: 51%

Ultra-Short Course of Neo-Adjuvant Denosumab for Nerve-Sparing Surgery for Giant Cell Tumor of Bone in Sacrum

Liang

Liu

Yang

et al. 2021

Spine

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“…Similar to osteoclasts, giant cells also express the RANK receptor on their surface, suggesting their formation as a result of fusion of monocytic precursors recruited by the stromal cells through the expression of RANKL, exactly as is the case for osteoclasts (Morgan et al, 2005). The high expression of RANKL within the tumor paved the way for the use of denosumab, a fully human monoclonal antibody to RANKL, as efficient treatment for GCT, reducing its lytic activity (Chawla et al, 2019;Alothman et al, 2020). Therefore, targeting giant cells is a more effective approach than targeting neoplastic stromal cells.…”

Section: Role Of Osteoclasts In Tumor Biology Primary Bone Tumorsmentioning

confidence: 99%

The Osteoclast Traces the Route to Bone Tumors and Metastases

Russo

Carlo

Gianfrancesco

2022

Front. Cell Dev. Biol.

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Osteoclasts are highly specialized cells of the bone, with a unique apparatus responsible for resorption in the process of bone remodeling. They are derived from differentiation and fusion of hematopoietic precursors, committed to form mature osteoclasts in response to finely regulated stimuli produced by bone marrow–derived cells belonging to the stromal lineage. Despite a highly specific function confined to bone degradation, emerging evidence supports their relevant implication in bone tumors and metastases. In this review, we summarize the physiological role of osteoclasts and then focus our attention on their involvement in skeletal tumors, both primary and metastatic. We highlight how osteoclast-mediated bone erosion confers increased aggressiveness to primary tumors, even those with benign features. We also outline how breast and pancreas cancer cells promote osteoclastogenesis to fuel their metastatic process to the bone. Furthermore, we emphasize the role of osteoclasts in reactivating dormant cancer cells within the bone marrow niches for manifestation of overt metastases, even decades after homing of latent disseminated cells. Finally, we point out the importance of counteracting tumor progression and dissemination through pharmacological treatments based on a better understanding of molecular mechanisms underlying osteoclast lytic activity and their recruitment from cancer cells.

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“…CT, magnetic resonance imaging (MRI), and positron emission tomography (PET) are useful for evaluating tumor response [ 52 , 53 ] and blood supply. Based on the inverse Choi density/size (ICDS) criteria assessed using CT or MRI images before and after treatment with denosumab, the majority of patients with GCTB have a significant tumor response [ 54 ]. Furthermore, PET helps assess early tumor response [ 55 ].…”

Section: Dose and Duration Of Therapy With Denosumab Affect The Blood...mentioning

confidence: 99%

Progress on Denosumab Use in Giant Cell Tumor of Bone: Dose and Duration of Therapy

Xiang

Liu

Deng

et al. 2022

Cancers

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Giant cell tumor of bone (GCTB) is an aggressive non-cancerous bone tumor associated with risks of sarcoma and metastasis. Once malignancy occurs, the prognosis is generally poor. Surgery remains the main treatment for GCTB. Multidisciplinary management is a feasible option for patients wherein surgical resection is not an option or for those with serious surgery-related complications. Denosumab is an anti-nuclear factor kappa B ligand approved for the treatment of postmenopausal women with osteoporosis, bone metastases, and advanced or inoperable GCTB. However, the guidelines for treating GCTB are unclear; its short-term efficacy and safety in inoperable patients have been demonstrated. Lengthier therapies (high cumulative doses) or pre-operative adjuvant therapy may be associated with severe complications and high local recurrence rates. Short-term administration helps attain satisfactory local control and functionality. As a result, lately, the impact of different doses and lengths of treatment on the efficacy of denosumab in GCTB treatment, the incidence of complications, and recurrence rates have gained attention. The efficacy and safety of denosumab against GCTB, its impact on imaging assessment, related complications, and recurrence of GCTB were previously reviewed. For further research direction, this paper reviews the progress of studies evaluating the impact of the dose and duration of denosumab therapy for GCTB.

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Giant cell tumor of bone following denosumab treatment: assessment of tumor response using various imaging modalities

Cited by 8 publications

References 17 publications

Ultra-Short Course of Neo-Adjuvant Denosumab for Nerve-Sparing Surgery for Giant Cell Tumor of Bone in Sacrum

Ultra-Short Course of Neo-Adjuvant Denosumab for Nerve-Sparing Surgery for Giant Cell Tumor of Bone in Sacrum

The Osteoclast Traces the Route to Bone Tumors and Metastases

Progress on Denosumab Use in Giant Cell Tumor of Bone: Dose and Duration of Therapy

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