Does Denosumab Change the Giant Cell Tumor Treatment Strategy? Lessons Learned From Early Experience

Clinical Orthopaedics and Related Research
Manish G AgarwalRajeev Reddy

Abstract

Although giant cell tumors (GCTs) are benign, their aggressiveness and tendency to recur locally challenge the orthopaedic surgeon's ability to perform joint-preserving intralesional surgery with an acceptably low risk of local recurrence. Denosumab has emerged as a possible medical treatment of GCT because it seems to halt the progression of GCT, alleviate pain, and increase perilesional bone formation, but its exact role has been questioned, and specifically its efficacy and associated complications are not well characterized. (1) Does denosumab reduce the risk of recurrence after resection or intralesional surgery? (2) What are the complications associated with the use of denosumab? Fifty-four patients with 30 primary and 25 recurrent tumors between November 2013 and July 2016 were treated with denosumab after a confirmed histopathologic diagnosis of GCT. Another 17 patients in the same period were treated without denosumab. During the study period, we encouraged the use of denosumab in all patients except those who refused, could not afford it, or where it was contraindicated (eg, in pregnancy). In all patients undergoing intralesional surgery, we arbitrarily planned six doses before surgery. Variations in total doses befor...Continue Reading

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Citations

May 27, 2020·Current Opinion in Oncology·Lizz van der HeijdenHans Gelderblom
Aug 4, 2020·Orthopedics·Shinji TsukamotoCostantino Errani
Sep 19, 2020·The International Journal of Neuroscience·Tarush RustagiEhud Mendel
Jul 6, 2020·Current Treatment Options in Oncology·Emanuela PalmeriniR Lor Randall
May 14, 2020·Clinical Orthopaedics and Related Research·Suraj HindiskerePramod S Chinder
Oct 24, 2020·International Orthopaedics·Gennady N Machak, Andrey I Snetkov
Oct 31, 2020·Frontiers in Oncology·Hengyuan LiZhaoming Ye
Feb 23, 2021·Current Osteoporosis Reports·Kristen S Pan, Alison M Boyce
Aug 8, 2021·Cancers·Shinji TsukamotoCostantino Errani

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