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Surgical Downstaging in an Open-Label Phase II Trial of Denosumab in Patients with Giant Cell Tumor of Bone

Title: Surgical Downstaging in an Open-Label Phase II Trial of Denosumab in Patients with Giant Cell Tumor of Bone
Authors: Rutkowski, P; Ferrari, S; Grimer, RJ; Stalley, PD; Dijkstra, SPD; Pienkowski, A; Vaz, G; Wunder, JS; Seeger, LL; Feng, A; Roberts, ZJ; Bach, BA
Source: Annals of Surgical Oncology, vol 22, iss 9
Publisher Information: eScholarship, University of California
Publication Year: 2015
Collection: University of California: eScholarship
Subject Terms: Oncology & Carcinogenesis; Oncology and Carcinogenesis
Time: 2860 - 2868
Description: Background: Surgical resection with curative intent for giant cell tumor of bone (GCTB) may be associated with severe morbidity. This interim analysis evaluated reduction in surgical invasiveness after denosumab treatment in patients with resectable GCTB. Methods: Patients with primary or recurrent GCTB, for whom the initially planned surgery was associated with functional compromise or morbidity, received denosumab 120mg subcutaneously every 4weeks (additional doses on days8 and 15 of the first cycle). Planned and actual GCTB-related surgical procedures before and after denosumab treatment were reported. Patients were followed for surgical outcome, adverse events, and recurrence following resection. Results: Overall, 222 patients were evaluable for surgical downstaging (54% were women; median age 34years). Lesions (67% primary and 33% recurrent) were located in the axial (15%) and appendicular skeleton (85%). At the data cutoff date, most patients had not yet undergone surgery (n=106; 48%) or had a less morbid procedure (n=84; 38%) than originally planned. Median (interquartile range) time on denosumab was 19.5 (12.4–28.6) months for the 106 patients who had not undergone surgery and were continuing on monthly denosumab. Native joint preservation was 96% (n=24/25) for patients with planned joint/prosthesis replacement and 86% (n=30/35) for patients with planned joint resection/fusion. Of the 116 patients who had surgery (median postsurgical follow-up 13.0 [8.5–17.9] months), local recurrence occurred in 17 (15%) patients. Conclusion: For patients with resectable GCTB, neoadjuvant denosumab therapy resulted in beneficial surgical downstaging, including either no surgery or a less morbid surgical procedure.
Document Type: article in journal/newspaper
File Description: application/pdf
Language: unknown
Relation: qt95x066rv; https://escholarship.org/uc/item/95x066rv; https://escholarship.org/content/qt95x066rv/qt95x066rv.pdf
DOI: 10.1245/s10434-015-4634-9
Availability: https://escholarship.org/uc/item/95x066rv; https://escholarship.org/content/qt95x066rv/qt95x066rv.pdf; https://doi.org/10.1245/s10434-015-4634-9
Rights: public
Accession Number: edsbas.55B66248
Database: BASE