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Denosumab decreases abnormal giant cells in patients with giant-cell tumor of the bone
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Denosumab increases bone formation and decreases the number of giant cells by 90% in patients with giant-cell tumor of the bone. Additionally, the drug may be useful in the treatment of patients with giant-cell tumor of the bone (GCTB) who surgeons may otherwise choose to recommend for joint replacement procedures, according to researchers from California.
“A majority of patients with giant-cell tumor of the bone are young and have to get joint replacements, which last 15 years to 20 years before a repeat surgery is needed,” Sant P. Chawla, MD, director of the Santa Monica Oncology Center in Santa Monica, California, stated in a press release. “Now, we hopefully can do minimal surgery, avoiding a joint replacement and recurrence.”
Results of the phase II study of denosumab (Prolia, Amgen), a drug that targets the receptor activator of nuclear factor kappa-B ligand, or RANK ligand, were published in Clinical Cancer Research.
In the study, patients with GCTB received 120 mg of denosumab every 4 weeks until all 20 patients’ tumors shrank, according to the abstract. Nearly two-thirds of those patients also had growth in areas where the RANK ligand previously caused bone destruction.
Chawla said the next step in the research is to analyze whether the drug is usable as a preoperative treatment.
“Radical surgery is currently the only treatment option. In our study, the use of denosumab allowed patients to avoid radical surgery and prevented recurrence. We hope that in the future, its use may make it possible to avoid surgery completely,” Chawla said.
Reference:
Branstetter DG, Nelson SD, Manivel JC, et al. Denosumab induces tumor reduction and bone formation in patients with giant-cell tumor of bone. Clin Cancer Res. 2012;18(16); 4415–4424. doi:10.1158/1078-0432.CCR-12-0578.
