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Rechallenge of denosumab in advanced giant cell tumor of the bone after atypical femur fracture: A case report and review of literature

Giant cell tumor of the bone (GCTB) is a locally aggressive neoplasm where surgery is often curative. However, it can rarely give rise to distant metastases. Currently, the only available active therapeutic option for unresectable GCTB is denosumab, an anti-RANKL monoclonal antibody that dampens the...

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Autores principales: Nasca, Vincenzo, Frezza, Anna Maria, Morosi, Carlo, Buonomenna, Ciriaco, Parafioriti, Antonina, Zappalà, Giorgio, Bini, Federica, Casali, Paolo Giovanni, Loppini, Mattia, Stacchiotti, Silvia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9343706/
https://www.ncbi.nlm.nih.gov/pubmed/35928864
http://dx.doi.org/10.3389/fonc.2022.953149
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author Nasca, Vincenzo
Frezza, Anna Maria
Morosi, Carlo
Buonomenna, Ciriaco
Parafioriti, Antonina
Zappalà, Giorgio
Bini, Federica
Casali, Paolo Giovanni
Loppini, Mattia
Stacchiotti, Silvia
author_facet Nasca, Vincenzo
Frezza, Anna Maria
Morosi, Carlo
Buonomenna, Ciriaco
Parafioriti, Antonina
Zappalà, Giorgio
Bini, Federica
Casali, Paolo Giovanni
Loppini, Mattia
Stacchiotti, Silvia
author_sort Nasca, Vincenzo
collection PubMed
description Giant cell tumor of the bone (GCTB) is a locally aggressive neoplasm where surgery is often curative. However, it can rarely give rise to distant metastases. Currently, the only available active therapeutic option for unresectable GCTB is denosumab, an anti-RANKL monoclonal antibody that dampens the aggressive osteolysis typically seen in this disease. For advanced/metastatic GCTB, denosumab should be continued lifelong, and although it is usually well tolerated, important questions may arise about the long-term safety of this drug. In fact, uncommon but severe toxicities can occur and eventually lead to denosumab discontinuation, such as atypical fracture of the femur (AFF). The optimal management of treatment-related AFF is a matter of debate, and to date, it is unknown whether reintroduction of denosumab at disease progression is a clinically feasible option, as no reports have been provided so far. Hereinafter, we present a case of a patient with metastatic GCTB who suffered from AFF after several years of denosumab; we describe the clinical features, orthopedic treatment, and oncological outcomes, finally providing the first evidence that denosumab rechallenge after AFF occurrence may be a safe and viable option at GCTB progression.
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spelling pubmed-93437062022-08-03 Rechallenge of denosumab in advanced giant cell tumor of the bone after atypical femur fracture: A case report and review of literature Nasca, Vincenzo Frezza, Anna Maria Morosi, Carlo Buonomenna, Ciriaco Parafioriti, Antonina Zappalà, Giorgio Bini, Federica Casali, Paolo Giovanni Loppini, Mattia Stacchiotti, Silvia Front Oncol Oncology Giant cell tumor of the bone (GCTB) is a locally aggressive neoplasm where surgery is often curative. However, it can rarely give rise to distant metastases. Currently, the only available active therapeutic option for unresectable GCTB is denosumab, an anti-RANKL monoclonal antibody that dampens the aggressive osteolysis typically seen in this disease. For advanced/metastatic GCTB, denosumab should be continued lifelong, and although it is usually well tolerated, important questions may arise about the long-term safety of this drug. In fact, uncommon but severe toxicities can occur and eventually lead to denosumab discontinuation, such as atypical fracture of the femur (AFF). The optimal management of treatment-related AFF is a matter of debate, and to date, it is unknown whether reintroduction of denosumab at disease progression is a clinically feasible option, as no reports have been provided so far. Hereinafter, we present a case of a patient with metastatic GCTB who suffered from AFF after several years of denosumab; we describe the clinical features, orthopedic treatment, and oncological outcomes, finally providing the first evidence that denosumab rechallenge after AFF occurrence may be a safe and viable option at GCTB progression. Frontiers Media S.A. 2022-07-19 /pmc/articles/PMC9343706/ /pubmed/35928864 http://dx.doi.org/10.3389/fonc.2022.953149 Text en Copyright © 2022 Nasca, Frezza, Morosi, Buonomenna, Parafioriti, Zappalà, Bini, Casali, Loppini and Stacchiotti https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Nasca, Vincenzo
Frezza, Anna Maria
Morosi, Carlo
Buonomenna, Ciriaco
Parafioriti, Antonina
Zappalà, Giorgio
Bini, Federica
Casali, Paolo Giovanni
Loppini, Mattia
Stacchiotti, Silvia
Rechallenge of denosumab in advanced giant cell tumor of the bone after atypical femur fracture: A case report and review of literature
title Rechallenge of denosumab in advanced giant cell tumor of the bone after atypical femur fracture: A case report and review of literature
title_full Rechallenge of denosumab in advanced giant cell tumor of the bone after atypical femur fracture: A case report and review of literature
title_fullStr Rechallenge of denosumab in advanced giant cell tumor of the bone after atypical femur fracture: A case report and review of literature
title_full_unstemmed Rechallenge of denosumab in advanced giant cell tumor of the bone after atypical femur fracture: A case report and review of literature
title_short Rechallenge of denosumab in advanced giant cell tumor of the bone after atypical femur fracture: A case report and review of literature
title_sort rechallenge of denosumab in advanced giant cell tumor of the bone after atypical femur fracture: a case report and review of literature
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9343706/
https://www.ncbi.nlm.nih.gov/pubmed/35928864
http://dx.doi.org/10.3389/fonc.2022.953149
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