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接受地诺单抗治疗的不可切除骨巨细胞瘤在停药后会进展吗?

Do Unresectable Giant Cell Tumors of Bone Treated With Denosumab Progress After Discontinuation of Treatment?

作者信息

de la Calva Carolina, Angulo Manuel, González-Rojo Paula, Peiró Ana, Machado Pau, Cebrián Juan Luis, García-Maroto Roberto, Valcárcel Antonio, Puertas Pablo, Valero-Cifuentes Gregorio, Pablos Óscar, Maireles Miriam, Fontalva María Luisa, Chaves Iván, Orce Aida, Coll-Mesa Luis, Pérez Israel, González Fausto, Del Carmen Sanz María, Gracia Isidro

机构信息

Hospital Universitario y Politécnico La Fe, Valencia, Spain.

Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.

出版信息

Cancer Rep (Hoboken). 2025 Jan;8(1):e70117. doi: 10.1002/cnr2.70117.

Abstract

BACKGROUND

Denosumab represents a valuable treatment option for unresectable giant cell tumors of the bone (GCTBs). However, no standardized protocols exist determining the length of administration, with few studies having been published on patients who reached the end of treatment.

AIMS

To analyze the outcomes of patients diagnosed with GCTB and who had finished single treatment with denosumab.

METHODS AND RESULTS

This is a multicenter, retrospective, descriptive study carried out in seven Spanish hospitals with multidisciplinary sarcoma and musculoskeletal tumor boards, between 2009 and 2019. Sixteen patients diagnosed with unresectable GCTBs and treated with denosumab who had reached the end of their treatment were recruited for the study and had been followed up for a minimum of 2 years. Fifty percent of patients discontinued denosumab after showing signs of tumor control. The disease remained stable in 69% of patients (n = 11), with a median recurrence-free survival time of 46 months (20-157 months) after being treated for a median period of 19 months (5-83 months). Four patients experienced local progression, and one presented multifocal progression. These five patients were treated for a median period of 46 months (14-76 months), with a median recurrence-free survival time of 9 months (5-25 months).

CONCLUSION

The findings of the present study suggest that discontinuation of denosumab in patients with unresectable GCTB is not necessarily associated with the progression of the disease. Further research is needed to determine how long denosumab should be administered to minimize the risk of recurrence.

摘要

背景

地诺单抗是不可切除骨巨细胞瘤(GCTB)的一种有价值的治疗选择。然而,目前尚无确定给药时长的标准化方案,关于完成治疗的患者的研究报道较少。

目的

分析诊断为GCTB并完成地诺单抗单药治疗的患者的结局。

方法与结果

这是一项多中心、回顾性、描述性研究,于2009年至2019年在西班牙七家设有多学科肉瘤和肌肉骨骼肿瘤委员会的医院开展。16例诊断为不可切除GCTB并接受地诺单抗治疗且已完成治疗的患者被纳入本研究,并接受了至少2年的随访。50%的患者在出现肿瘤控制迹象后停用了地诺单抗。69%的患者(n = 11)疾病保持稳定,接受中位时长19个月(5 - 83个月)治疗后,无复发生存时间的中位数为46个月(20 - 157个月)。4例患者出现局部进展,1例出现多灶性进展。这5例患者的中位治疗时长为46个月(14 - 76个月),无复发生存时间的中位数为9个月(5 - 25个月)。

结论

本研究结果表明,不可切除GCTB患者停用 地诺单抗不一定与疾病进展相关。需要进一步研究以确定地诺单抗应给药多长时间以将复发风险降至最低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dcc7/11726647/c9a7b9fbb7d4/CNR2-8-e70117-g001.jpg

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