Denosumab does not decrease the risk of lung metastases from bone giant cell tumour
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There are conflicting reports on the effect of denosumab on lung metastases in patients with giant cell tumor (GCT) of bone. To address these reports, we performed this study to determine if denosumab prevents lung metastasis and to evaluate univariate and multivariate predictors for lung metastases in these patients.
Materials and methods
We retrospectively studied 381 GCT patients with surgery alone and 30 GCT patients with surgery and denosumab administration. The median follow-up was 85.2 months (IQR, 54.2–124.4 months). We evaluated lung metastases and local recurrences, univariate and multivariate predictors for lung metastases, response, and adverse events of denosumab administration.
The occurrence of lung metastases was similar (surgery alone 4.7%, 18 patients; denosumab administration 3.3%, 1 patient); however, the occurrence of local recurrences was significantly higher in the patients with denosumab administration. Denosumab administration was not an important predictor for lung metastases; Campanacci stage and type of surgery were the only univariate predictors for lung metastases, and type of surgery and local recurrence were the only multivariate predictors for lung metastases. Histology showed viable tumour in all tumor specimens of the patients with denosumab administration.
Denosumab does not decrease the risk of lung metastases in patients with bone GCT; the only important predictors for lung metastases in these patients are type of surgery and local recurrence. However, because the number of patients with lung metastases was small for a multivariate analysis, the possibility of denosumab’s effect could not be completely eliminated.
KeywordsGiant cell tumour of bone Denosumab Metastasis Lungs
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
This study was approved by the independent ethics committee of senior author’s institution and is registered with ClinicalTrials.gov (identifier NCT02996734).
Informed consent was obtained from all individual participants included in the study.
- 1.Fletcher CDM, Bridge JA, Hogendoorn P, Mertens F (2013) WHO classification of tumours of soft tissue and bone. Lyon, IARC, pp 321–324Google Scholar
- 12.Chawla S, Henshaw R, Seeger L et al (2013) Safety and efficacy of denosumab for adults and skeletally mature adolescents with giant cell tumour of bone: interim analysis of an open-label, parallel-group, phase 2 study. Lancet Oncol 14:901–908. https://doi.org/10.1016/S1470-2045(13)70277-8 CrossRefPubMedGoogle Scholar
- 23.Choi H, Charnsangavej C, Faria SC et al (2007) Correlation of computed tomography and positron emission tomography in patients with metastatic gastrointestinal stromal tumor treated at a single institution with imatinib mesylate: proposal of new computed tomography response criteria. J Clin Oncol 25:1753–1759. https://doi.org/10.1200/JCO.2006.07.3049 CrossRefPubMedGoogle Scholar
- 24.U.S. Department of Health and Human Services, National Institutes of Health, National Cancer Institute (2009) Common Terminology Criteria for Adverse Events (CTCAE) version 4.0. U.S. May 28. Available at: https://ctep.cancer.gov/protocoldevelopment/electronic_applications/ctc.htm#ctc_40. Accessed on: April 14, 2018
- 25.Bacci G, Rocca M, Salone M et al (2008) High grade osteosarcoma of the extremities with lung metastases at presentation: treatment with neoadjuvant chemotherapy and simultaneous resection of primary and metastatic lesions. J Surg Oncol 98(6):415–420. https://doi.org/10.1002/jso.21140 CrossRefPubMedGoogle Scholar