骨巨细胞瘤患者用狄诺塞麦能治愈吗？

Giant cell tumor of bone (GCTB) is an aggressive, osteolytic lesion rich in giant cells, characterized by the accumulation of large numbers of multinucleated osteoclast-like giant cells expressing the nuclear factor JCB receptor activator ligand (RANKL). Currently, there is no method that can completely and effectively cure it, especially for inoperable GCTB. (denosumab) is a human RANKL monoclonal antibody that binds to receptor activator of nuclear factor wB (RANK) with high affinity and specificity. Many previous large-scale phase III trial studies have shown that denosumab (denosumab) is significantly better than bisphosphonates in reducing bone destruction caused by various tumors, and can also delay the occurrence of bone metastasis.

Denosumab (denosumab) works by inhibiting osteoclasts, thereby reducing bone loss. Because the tumor cells in giant cell tumors of bone are very similar to osteoclasts, this drug has been borrowed into the treatment of giant cell tumors of bone. Through a series of clinical observations, it was found that denosumab (denosumab) can cause massive necrosis in giant cell tumors of bone. Its effect is better than the previously used bisphosphonates and interferons, and its side effects are also less than the above two drugs. If medication is started before surgery, the surgery can sometimes be simplified and the recurrence of tumors after surgery can be reduced. For patients with recurrence, the drug can shrink the tumor and facilitate re-operation.

Denosumab (denosumab) is extremely convenient to use. It only needs to be used once a month and is injected subcutaneously. Although tooth loss and osteonecrosis of the jaw have been reported, the incidence is low.

A phase II clinical study of 282 cases showed that 96% of patients who could not be removed by surgery did not progress within a median time of 13 months after using denosumab (denosumab); 100 patients required high-level surgical treatment at the beginning of the study. After 9.2 months of treatment with denosumab (denosumab), 74 patients no longer required surgical treatment, and 16 of the remaining 26 patients underwent low-level surgical treatment. Corresponding side effects occurred during treatment, with 1% to 10% of patients experiencing headache and bone pain; 1% to 2% of patients experiencing osteonecrosis of the jaw; and less than 0.01% of patients experiencing hypocalcemia and hypophosphatemia. Although (denosumab) has achieved certain clinical efficacy, whether it can completely cure giant cell tumor of bone still requires further research.

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