Efficacy of Neoadjuvant Denosumab on Tumor Recurrence, Ossification, and Surgical Outcomes in Patients With Grade III Giant Cell Tumor of Bone: A Prospective, Non-Randomized Comparative Interventional Study

IF 2.1 4区医学 Q4 ONCOLOGY

Asia-Pacific journal of clinical oncology Pub Date : 2026-10-22 Epub Date: 2026-08-13 DOI:10.1111/ajco.70153

Mehdi Karimi, Samira Pirzad, Kimia Habibi, Masoud Mirkazemi

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引用次数: 0

Abstract

Background

Giant cell tumor of bone (GCTB) is a rare, locally aggressive osteolytic neoplasm associated with a substantial risk of local recurrence and challenging surgical management. Denosumab, a monoclonal antibody, has emerged as a promising therapeutic option. This study evaluates the efficacy of denosumab as a neoadjuvant therapy in patients with Grade III GCTB, with particular emphasis on tumor recurrence, ossification, and surgical outcomes.

Methods

In this prospective, non-randomized comparative interventional study, 34 adults with histologically confirmed Campanacci Grade III GCTB were enrolled and prospectively followed. Sixteen patients received neoadjuvant denosumab and 18 contemporaneous patients underwent surgery without neoadjuvant denosumab. Treatment allocation was based on routine clinical decision-making and patient-specific factors rather than randomization.

Results

During the 18-month follow-up period, local recurrence occurred in 2 of 16 patients (12.5%) in the denosumab intervention group and in 8 of 18 patients (44.4%) in the comparison group (p = 0.063). Radiological ossification was observed in all patients in the denosumab group and in none of the patients in the comparison group. Curettage and cementation were performed in 14 patients (87.5%) in the intervention group and 12 patients (66.7%) in the comparison group; this difference was not statistically significant (p = 0.233). Qualitative histopathological assessment of available specimens from denosumab-treated patients demonstrated marked depletion or disappearance of osteoclast-like giant cells, accompanied by treatment-related changes including new bone formation, fibrosis, and hemorrhage.

Conclusion

In this study, neoadjuvant denosumab was associated with complete radiological ossification, qualitative histopathological changes characterized by marked depletion of osteoclast-like giant cells, and numerically lower observed local recurrence and greater use of curettage and cementation, although the latter two between-group differences were not statistically significant.

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新佐剂Denosumab对III级骨巨细胞瘤患者肿瘤复发、骨化和手术结局的疗效：一项前瞻性、非随机对照介入研究

背景：骨巨细胞瘤（GCTB）是一种罕见的局部侵袭性溶骨性肿瘤，具有局部复发的风险，手术治疗具有挑战性。Denosumab是一种单克隆抗体，已成为一种有前景的治疗选择。本研究评估了denosumab作为III级GCTB患者新辅助治疗的疗效，特别强调了肿瘤复发、骨化和手术结果。方法：在这项前瞻性、非随机对照介入研究中，纳入了34例组织学证实的Campanacci III级GCTB成人患者，并进行了前瞻性随访。16例患者接受了新辅助的地诺单抗治疗，同期18例患者接受了不使用新辅助的地诺单抗的手术。治疗分配基于常规临床决策和患者特异性因素，而不是随机化。结果：在18个月的随访期间，denosumab干预组16例患者中有2例（12.5%）出现局部复发，对照组18例患者中有8例（44.4%）出现局部复发（p = 0.063）。denosumab组中所有患者均观察到放射学骨化，而对照组中没有患者观察到。干预组14例（87.5%），对照组12例（66.7%）；差异无统计学意义（p = 0.233）。对denosumab治疗患者的标本进行定性组织病理学评估，发现破骨细胞样巨细胞明显减少或消失，伴有治疗相关的变化，包括新骨形成、纤维化和出血。结论：在本研究中，新辅助denosumab与完全的放射学骨化、定性的组织病理学改变（以破骨细胞样巨细胞明显耗竭为特征）、较低的局部复发率和更多的刮除和骨水泥的使用相关，尽管后两者在组间差异无统计学意义。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Asia-Pacific journal of clinical oncology 医学-肿瘤学

CiteScore

3.40

自引率

0.00%

发文量

175

审稿时长

6-12 weeks

期刊介绍： Asia–Pacific Journal of Clinical Oncology is a multidisciplinary journal of oncology that aims to be a forum for facilitating collaboration and exchanging information on what is happening in different countries of the Asia–Pacific region in relation to cancer treatment and care. The Journal is ideally positioned to receive publications that deal with diversity in cancer behavior, management and outcome related to ethnic, cultural, economic and other differences between populations. In addition to original articles, the Journal publishes reviews, editorials, letters to the Editor and short communications. Case reports are generally not considered for publication, only exceptional papers in which Editors find extraordinary oncological value may be considered for review. The Journal encourages clinical studies, particularly prospectively designed clinical trials.