A case of long-term use of denosumab for giant cell tumor of bone
https://doi.org/10.17650/3034-2473-2024-1-3-49-54
Abstract
Giant cell tumor of bone is a locally aggressive primary bone neoplasm affecting patients aged 20–50 years. Neoplastic stromal cells have a phenotype of immature osteoblasts synthesizing various cytokines and molecular factors leading to excessive activation of osteoclastogenesis and increased osteolysis in giant cell tumor of bone. Long-term treatment with denosumab is recommended for unresectable or disseminated disease.
A clinical case of long-term treatment with denosumab of initially generalized giant cell tumor of the right ischial bone with metastases to the lungs is presented. Stabilization of the process was first recorded 3 months after the start of therapy and has been maintained to date. The patient was transferred to a maintenance regimen 3 years after the start of treatment. The treatment was not accompanied by adverse events characteristic of bone-modifying agents.
Long-term use of denosumab allowed effective control of the tumor process and maintenance of satisfactory quality of life of the patient. Maintenance regimen of denosumab administration was not accompanied by a decrease in treatment effectiveness.
About the Authors
L. Yu. VladimirovaRussian Federation
Lyubov Yurievna Vladimirоva
63 14th Liniya St., Rostov-on-Don 344037
N. A. Abramova
Russian Federation
63 14th Liniya St., Rostov-on-Don 344037
L. N. Vashchenko
Russian Federation
63 14th Liniya St., Rostov-on-Don 344037
A. A. Barashev
Russian Federation
63 14th Liniya St., Rostov-on-Don 344037
N. M. Tikhanovskaya
Russian Federation
63 14th Liniya St., Rostov-on-Don 344037
References
1. Andrievskikh E.A., Zinoviev G.V., Gafton G.I. et al. Giant cell tumor of bone: a textbook for students. Saint Petersburg: N.N. Petrov National Medical Research Center of Oncology, 2022. 56 p. (In Russ.).
2. Luengo‑Alonso G., Mellado‑Romero M., Shemesh S. et al. Denosumab treatment for giant-cell tumor of bone: a systematic review of the literature. Arch Orthop Trauma Surg 2019;139:1339–49. DOI: 10.1007/s00402-019-03167-x
3. Kito M., Matusmoto S., Tanizawa K. et al. Pulmonary metastasis from giant cell tumor of bone: clinical outcome prior to the introduction of molecular target therapy. Jap J Clin Oncol 2017;6(47):529–34. DOI: 10.1093/jjco/hyx033
4. Yang Y., Huang Z., Niu X. et al. Clinical characteristics and risk factors analysis of lung metastasis of benign giant cell tumor of bone. J Bone Oncol 2017;7:23–8. DOI: 10.1016/j.jbo.2017.04.001
5. Itkin B., Straminsky S., De Ronato G. et al. Prognosis of metastatic giant cell tumor of bone in the pre-denosumab era. A systematic review and a meta-analysis. Jpn J Clin Oncol 2018;48(7):640–52. DOI: 10.1093/jjco/hyy067
6. Gershtein E.S., Timofeev Yu.S., Zuev A.A., Kushlinskiy N.E. RANK/RANKL/OPG ligand-receptor system and its role in primary bone neoplasms (literature analysis and own data). Uspekhi molekulyarnoi onkologii = Advances in Molecular Oncology 2015;(3): 51–9. (In Russ.). DOI: 10.17650/2313-805X.2015.2.3.51-59
7. Valiev A.K., Tararykova A.A., Teplyakov V.V. et al. Practical recommendations for drug treatment of malignant bone tumors. Practical recommendations RUSSCO, part 1. Zlokachestvenniye opukholi = Malignant Tumors 2023;13(3s2):335–55. (In Russ.). DOI: 10.18027/2224-5057-2023-13-3s2-1-335-355
8. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) with NCCN Evidence Blocks™. Version 2.2024. 2024. Available at: https://www.nccn.org/guidelines/guidelines-withevidence-blocks
9. Kajizono M., Sada H., Sugiura Y. et al. Incidence and risk factors of osteonecrosis of the jaw in advanced cancer patients after treatment with zoledronic acid or denosumab: a retrospective cohort study. Biol Pharm Bull 2015;38(12):1850–5. DOI: 10.1248/bpb.b15-00385
10. Nakata E., Kunisada T., Fujiwara T. et al. Efficacy and safety of denosumab de‑escalation in giant cell tumor of bone. Oncol Lett 2024;28(2):387. DOI: 10.3892/ol.2024.14520
11. Schilcher J., Aspenberg P. Atypical fracture of the femur in a patient using Denosumab – a case report. Acta Orthop 2014;85(1):6–7. DOI: 10.3109/17453674.2014.885355
12. Chawla S., Blay J.Y., Rutkowski P. et al. Denosumab in patients with giant-cell tumour of bone: a multicentre, open-label, phase 2 study. Lancet Oncol 2019;20:1719–29. DOI: 10.1016/S1470-2045(19)30663-1
13. Tararykova A.A., Fedenko A.A., Musaev E.R. et al. Safety and effectiveness of continuous denosumab for unresectable or advanced giant cell tumor. Sarkomy kostei myagkikh tkanei i opukholi kozhi = Bone and Soft Tissue Sarcomas, Tumors of the Skin 2023;15(1):57–65. (In Russ.). DOI: 10.17650/2782-3687-2023-15-1-57-65
14. Palmerini E., Chawla N.S., Ferrari S. et al. Denosumab in advanced/unresectable giant-cell tumour of bone (GCTB): for how long? Eur J Cancer 2017;76:118–24. DOI: 10.1016/j.ejca.2017.01.028
15. Jiang C.Y., Zhao L., Schuetze S.M., Chugh R. Giant cell tumor of bone: effect of longer dosing intervals of denosumab on tumor control and bone-related complications. Oncologist 2022;27(7):595–9. DOI: 10.1093/oncolo/oyac066
Review
For citations:
Vladimirova L.Yu., Abramova N.A., Vashchenko L.N., Barashev A.A., Tikhanovskaya N.M. A case of long-term use of denosumab for giant cell tumor of bone. Supportive Therapy in Oncology. 2024;1(3):49-54. (In Russ.) https://doi.org/10.17650/3034-2473-2024-1-3-49-54