Giant Step Forward for Giant-Cell Tumor of the Bone

Denosumab may effectively treat giant cell tumor of the bone

(RxWiki News) Denosumab – sold under the brand names of Prolia for the treatment of osteoporosis and Xgeva for fracture prevention in patients with metastatic cancers to the bone – may be effective in treating people with a condition known as giant-cell tumor of the bone.

This rare disease – that is not cancer – appears mostly in young adults (25-40), and the only treatment has been surgery. This drug may offer better options.

"If you have bone pain that doesn’t go away, see your doctor."

Sant P. Chawla, MD, director of the Santa Monica Oncology Center in Santa Monica, California, led the study

“Radical surgery is currently the only treatment option. In our study, the use of denosumab allowed patients to avoid radical surgery and prevented recurrence,” Dr. Chawla said.

“We hope that in the future, its use may make it possible to avoid surgery completely.”

Giant cell bone tumors of the bone are seen more often in women than in men. The tumors appear in the long bones – such as the femur (thigh bone).

The giant cells contain a protein called RANK ligand which is involved in the destruction of bone.

Surgery for this disease can be brutal and include amputation. Along with the surgery to remove the tumors, between 25-30 percent of patients have to have joint replacement surgery.

Dr. Chawla and colleagues conducted a phase 2 study involving 20 patients with giant-cell tumor of the bone that had either returned (recurrent) or was inoperable.

Participants received injections of denosumab every four weeks.

All of the patients saw a huge – 90 percent or more – decrease in giant cells. In addition, 65 percent of these folks saw new bone growth in areas the disease had previously destroyed.

“Now, we hopefully can do minimal surgery, avoiding a joint replacement and recurrence,” Dr. Chawla said in a press release.

To validate these findings, a large multi-national study is under way and currently enrolling patients

Dr. Chawla is also interested in testing to see if the medication would be useful as a treatment before surgery.

Denosumab works by targeting the RAND ligand. The medicine is approved for treating breast and prostate cancer-related bone loss, bone metastases and osteoporosis.

This study, which was funded by Amgen, the maker of both Prolia and Xgeva, was published in September 21 in Clinical Cancer Research, a journal of the American Association for Cancer Research.

No conflicts of interest were reported.

Review Date: 
September 27, 2012