title: Bisphosphonate treatment of aggressive primary, recurrent and metastatic Giant Cell Tumour of Bone.
abstract: BACKGROUND
  Giant cell tumour of bone (GCTB) is an expansile osteolytic tumour which contains numerous osteoclast-like giant cells. GCTB frequently recurs and can produce metastatic lesions in the lungs. Bisphosphonates are anti-resorptive drugs which act mainly on osteoclasts.
  
  
  METHODS
  In this study, we have examined clinical and radiological outcomes of treatment with aminobisphosphonates on 25 cases of aggressive primary, recurrent and metastatic GCTB derived from four European centres. We also analysed in vitro the inhibitory effect of zoledronic acid on osteoclasts isolated from GCTBs.
  
  
  RESULTS
  Treatment protocols differed with several different aminobisphosphonates being employed, but stabilisation of disease was achieved in most of these cases which were refractory to conventional treatment. Most inoperable sacral/pelvic tumours did not increase in size and no further recurrence was seen in GCTBs that had repeatedly recurred in bone and soft tissues. Lung metastases did not increase in size or number following treatment. Zoledronic acid markedly inhibited lacunar resorption by GCTB-derived osteoclasts in vitro.
  
  
  CONCLUSIONS
  Our findings suggest that bisphosphonates may be useful in controlling disease progression in GCTB and that these agents directly inhibit GCTB - derived osteoclast resorption. These studies highlight the need for the establishment of standardised protocols to assess the efficacy of bisphosphonate treatment of GCTB.
authors.affiliation: Department of Orthopaedic Surgery, University of Munster, Munster, Germany.
authors.forename: Maurice
authors.initials: M
authors.lastname: Balke
authors.forename: Laura
authors.initials: L
authors.lastname: Campanacci
authors.forename: Carsten
authors.initials: C
authors.lastname: Gebert
authors.forename: Piero
authors.initials: P
authors.lastname: Picci
authors.forename: Max
authors.initials: M
authors.lastname: Gibbons
authors.forename: Richard
authors.initials: R
authors.lastname: Taylor
authors.forename: Pancras
authors.initials: P
authors.lastname: Hogendoorn
authors.forename: Judith
authors.initials: J
authors.lastname: Kroep
authors.forename: John
authors.initials: J
authors.lastname: Wass
authors.forename: Nicholas
authors.initials: N
authors.lastname: Athanasou
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000188:drug therapy* / Q000556:secondary; D001862:Bone Resorption; D004164:Diphosphonates / Q000627:therapeutic use*; D005260:Female; D018212:Giant Cell Tumor of Bone / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007093:Imidazoles / Q000627:therapeutic use*; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000473:pathology; D010010:Osteoclasts / Q000187:drug effects / Q000473:pathology; D016896:Treatment Outcome; D014407:Tumor Cells, Cultured; D055815:Young Adult; D000077211:Zoledronic Acid
chemical_list: D000970:Antineoplastic Agents; D004164:Diphosphonates; D007093:Imidazoles; D000077211:Zoledronic Acid
references.citation: Acta Orthop Scand. 1996 Jun;67(3):221-8
references.pmid: 8686457
references.citation: J Clin Pathol. 1990 Dec;43(12):997-1003
references.pmid: 2266187
references.citation: Sarcoma. 2003;7(1):35-41
references.pmid: 18521367
references.citation: J Bone Miner Res. 1997 Oct;12(10):1746-52
references.pmid: 9333137
references.citation: Clin Orthop Relat Res. 2000 Apr;(373):104-14
references.pmid: 10810467
references.citation: Skeletal Radiol. 2009 Jan;38(1):5-9
references.pmid: 18649076
references.citation: Am J Clin Oncol. 2006 Feb;29(1):96-9
references.pmid: 16462511
references.citation: Postgrad Med J. 2004 Apr;80(942):190-5
references.pmid: 15082837
references.citation: J Bone Joint Surg Am. 1999 Jun;81(6):811-20
references.pmid: 10391546
references.citation: Clin Orthop Relat Res. 2001 Jan;(382):6-12
references.pmid: 11154006
references.citation: J Dent Res. 2007 Nov;86(11):1022-33
references.pmid: 17959891
references.citation: Lab Invest. 1994 Oct;71(4):465-71
references.pmid: 7526033
references.citation: Orthop Clin North Am. 2006 Jan;37(1):35-51
references.pmid: 16311110
references.citation: Lancet Oncol. 2010 Mar;11(3):275-80
references.pmid: 20149736
references.citation: J Pediatr Hematol Oncol. 2001 Jan;23(1):54-6
references.pmid: 11196272
references.citation: Annu Rev Pharmacol Toxicol. 1998;38:375-88
references.pmid: 9597160
references.citation: J Pain Symptom Manage. 2009 Aug;38(2):244-57
references.pmid: 19364633
references.citation: Clin Orthop Relat Res. 2004 Sep;(426):103-9
references.pmid: 15346059
references.citation: Bone. 1996 Jan;18(1):9-14
references.pmid: 8717530
references.citation: Cancer. 2000 Jun 15;88(12 Suppl):2961-78
references.pmid: 10898340
references.citation: Hum Pathol. 2005 Sep;36(9):945-54
references.pmid: 16153456
references.citation: J Bone Joint Surg Am. 1987 Jan;69(1):106-14
references.pmid: 3805057
references.citation: Calcif Tissue Int. 2004 Jul;75(1):71-7
references.pmid: 15037971
references.citation: J Bone Miner Res. 1995 Oct;10(10):1478-87
references.pmid: 8686503
references.citation: J Med Assoc Thai. 2008 Oct;91(10):1609-12
references.pmid: 18972907
references.citation: Bone. 2008 Jan;42(1):68-73
references.pmid: 17962092
references.citation: Ultrastruct Pathol. 2003 Nov-Dec;27(6):385-91
references.pmid: 14660277