Denosumab in Patients with Giant Cell Tumor and Its Recurrence: A Systematic Review

Abstract

Recent studies suggest that Denosumab reduces tumor size, therefore, makes the surgery easier with lower<br />morbidity. However, some studies have reported several complications for this drug. So, this systematic review<br />was performed to determine the effectiveness and safety of Denosumab in reducing bone destructions activity of<br />giant cell tumor and skeletal-related events (SRE) in affected patients with giant cell tumor of bone (GCTB) and its<br />recurrence.<br />We explored studies in PubMed, and Cochrane Library. For this purpose, articles of various levels were retrieved<br />until October 22, 2016. Two reviewers assessed the articles independently based on predefined criteria to extract the<br />relevant data. Primary outcomes associated with skeletal-related event, overall survival, and secondary outcomes<br />such as pain, quality of life and adverse events were evaluated and analyzed.<br />The total population of this meta-analysis consisted of 686 patients. Of this population, 55% had primary GCTB and<br />45% had giant cell tumor recurrence, with 2% experiencing secondary recurrence.<br />The results showed the effectiveness of Denosumab in reducing the tumor size due to inhibiting the Osteoclastogenesis.<br />Denosumab didnot show any effect on reducing tumor recurrence, but, in cases where complete tumor surgery is<br />not possible and tumor residuals may remain, Denosumab can be helpful. Also, the clinicians should consider the<br />risk benefit of Denosumab.