Denosumab for giant cell tumour of bone: success and limitations

Intralesional surgery, with or without local adjuvant, or en-bloc resection is the treatment of choice for giant-cell tumor of bone. However, recurrence rates remain high (10–50%), and surgery for tumour in common locations such as the pelvis and spine have unacceptably high morbidity. Improved targeted therapy for local and systemic control is needed. The eponymously named multinucleated giant cells are reactive and not neoplastic. The true neoplastic cells are bone forming mesenchymal stem-like cells that induce and drive the giant cells by mechanisms under study. 1 Chawla S Blay J-Y Rutowski P et al. Denosumab in patients with giant cell tumour of bone: a multicentre, open-label, phase 2 study. Lancet Oncol. 2019; (published online Oct 22)https://doi.org/10.1016/S1470-2045(19)30663-1 Summary Full Text Full Text PDF PubMed Scopus (94) Google Scholar Nevertheless, new therapies have focused on disrupting the reactive giant cells and their communication with the neoplastic mesenchymal cells. Denosumab in patients with giant-cell tumour of bone: a multicentre, open-label, phase 2 studyThe types and frequencies of adverse events were consistent with the known safety profile of denosumab, which showed long-term disease control for patients with GCTB with unresectable and resectable tumours. Our results suggest that the overall risk to benefit ratio for denosumab treatment in patients with GCTB remains favourable. Full-Text PDF