Progress of Denosumab in the treatment of giant cell tumor of bone

Denosumab is a fully human monoclonal antibody on receptor activator of NF-κB ligand that has shown adjuvant treatment for giant cell tumour of bone (GCT). Clinical trials show that over 85% of patients have significantly improved their clinical symptoms, imaging and histology. Currently mainly used for central axis bone such as the sacrum and spine of difficult surgical excision or limb recurrence or refractory GCT patients. Case reports have demonstrated complete response or tumor stabilization with denosumab, allowing for surgical procedures in simplify. However, the duration of the medication and the optimal therapeutic dose and long-term effects are not yet known. The local high recurrence rate after discontinuation of the drug remains a problem with the accumulation of clinical research, and the follow-up time is prolonged. More noteworthy is the possibility of pseudosarcoma, even malignant transformation after Denosumab treatment. This sarcoma transformation requires further controlled studies and long-term of follow-up to reach a definitive conclusion. In this paper, we retrospective analysis of the application status, imaging and histology related research of Denosumab in the treatment of GCT. Correct understanding of the value and clinical significance of this drug in GCT treatment requires a multi-center study and a long-term follow-up to evaluate the clinical value.