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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...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Frontiers Media S.A.
2022
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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. |
format | Online Article Text |
id | pubmed-9343706 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
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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