Denosumab in advanced/unresectable giant-cell tumour of bone (GCTB): For how long?

Palmerini, Emanuela; Chawla, Neal Shiv; Ferrari, Stefano; Sudan, Madhuri; Picci, Piero; Marchesi, Emanuela; Leopardi, Martina Piccinni; Syed, Imran; Sankhala, Kamalesh; Parthasarathy, Prarthana; Mendanha, William Esteves; Pierini, Michela; Paioli, Anna; Chawla, Sant P.

doi:10.1016/j.ejca.2017.01.028

Cited by 129 publications

(125 citation statements)

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“…Although long-term outcomes are pending, denosumab appears to be beneficial, especially for patients with unresectable GCTBs. 22 However, as our study, importantly, showed, H3F3A mutant cells with osteoblastic properties survive the therapy. Although G34W+ cell numbers decreased in some of our tumours, owing to denosumab therapy (Table 3), it remains unclear whether this agent can be considered to constitute a radical treatment.…”

Section: Discussionmentioning

confidence: 58%

“…Denosumab alleviated the osteolytic nature of GCTB and improved patients’ symptoms. Although long‐term outcomes are pending, denosumab appears to be beneficial, especially for patients with unresectable GCTBs . However, as our study, importantly, showed, H3F3A mutant cells with osteoblastic properties survive the therapy.…”

Section: Discussionmentioning

confidence: 64%

“…1 Previous studies found instances of sarcomatous transformation arising in GCTBs treated with denosumab, 23,24 and there have been several suggestions regarding the ideal length of denosumab therapy and monitoring procedures. 22,[25][26][27] Further studies are required to determine the best therapeutic strategy.…”

Section: Discussionmentioning

confidence: 99%

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Giant cell tumours of bone treated with denosumab: histological, immunohistochemical and H3F3A mutation analyses

et al. 2018

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Section: Discussionmentioning

confidence: 58%

Section: Discussionmentioning

confidence: 64%

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Giant cell tumours of bone treated with denosumab: histological, immunohistochemical and H3F3A mutation analyses

et al. 2018

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“…22-26 However, recently denosumab, a RANKL inhibitor, has been approved by the US Food and Drug Administration for adults and skeletally mature adolescents with unresectable GCTB or when surgical resection is likely to result in severe morbidity. 50 Sclerosis in postoperative CT scans of all the patients who received bisphosphonates along with no recurrence of tumor in the bisphosphonate group signifies that bisphosphonates in the postoperative period have a positive effect on the final disease outcome. It also implies that bisphosphonates are good and safe adjuvants that can be used effectively with appropriate surgical modality.…”

Section: Giant Cell Tumor Of Bone Was First Reported Bymentioning

confidence: 93%

Role of Bisphosphonates as Adjuvants of Surgery in Giant Cell Tumor of Spine

et al. 2018

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Background: The role of bisphosphonates is well established in giant cell tumor of bone (GCTB) of extremities, but its role in spine GCTB is still not established. Our main purpose was to evaluate the role of bisphosphonates in spinal GCTB with the help of radiologic assessment.Methods: A retrospective analysis of all spine GCTB patients who underwent an operation from July 2005 to January 2014 was done. Patients of spine GCTB in whom bisphosphonates were given constituted the study group. This group was compared to patients in whom bisphosphonates were not given. Preoperative and postoperative radiographs and CT scans were studied. A thorough evaluation of the presence of sclerosis was done on them. Bisphosphonates were considered to be effective if either sclerosis or new bone formation was present.Results: A total of 13 cases of spine GCT underwent operation from July 2005 to January 2014. All patients of GCTB spine who underwent an operation after 2008 at our institute were given bisphosphonates postoperatively. Of 13 cases, bisphosphonates were given postoperatively in 6 patients: 5 patients were female and 1 patient was male. Of these 6 patients, 3 patients had sacrum GCTB and 1 patient each had T9, T11, and L5 vertebrae GCTB. Average follow-up period was 39.33 months (minimum follow-up was 18 months and maximum follow-up was 72 months). Postoperative sclerosis was present in all 6 patients. No recurrence of the tumor was present in the bisphosphonate group, but 2 patients had a recurrence in the group that did not receive bisphosphonates.Conclusions: Bisphosphonates are effective and safe adjuvant therapy along with appropriate surgical intervention in spinal GCTBs and may have a role in decreasing the recurrence of this tumor.

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“…Optimal treatment schedule and duration are still unknown. A recently published paper by Palmerini et al 24 showed that prolonged treatment with denosumab (average duration of 54 months; range 9–115 months) attained good antitumoural activity in GCTs, with a mild toxicity profile, provided the strict monitoring of patients. In this same paper, authors have shown tumour recurrence in 40% of patients after treatment discontinuation.…”

Section: Treatmentmentioning

confidence: 99%

Recurrent giant cell tumour of the maxillary sinus and pterygoid process treated with denosumab

Rosa¹,

Dias²,

Salvador³

et al. 2018

BMJ Case Reports

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We report the case of a 74-year-old man with a giant cell tumour (GCT) of the right maxilla and pterygoid process. The patient presented to the maxillofacial and head and neck surgery clinic with an ulcerated lesion of the hard palate. Initial workup with CT revealed a mass within the right maxillary sinus and pterygoid process with associated bone expansion and erosion. Biopsy showed a GCT with mucosal ulceration. Two years after surgical resection, a follow-up CT revealed tumour recurrence involving the right pterygoid process and lateral pterygoid muscle. The patient was then proposed for therapy with denosumab. Under denosumab treatment, the lesion maintained stable dimensions and became sclerotic and heavily ossified.

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Denosumab in advanced/unresectable giant-cell tumour of bone (GCTB): For how long?

Cited by 129 publications

References 13 publications

Giant cell tumours of bone treated with denosumab: histological, immunohistochemical and H3F3A mutation analyses

Giant cell tumours of bone treated with denosumab: histological, immunohistochemical and H3F3A mutation analyses

Role of Bisphosphonates as Adjuvants of Surgery in Giant Cell Tumor of Spine

Recurrent giant cell tumour of the maxillary sinus and pterygoid process treated with denosumab

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