Bisphosphonate treatment of aggressive primary, recurrent and metastatic Giant Cell Tumour of Bone.
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.
Balke
Maurice
M
Department of Orthopaedic Surgery, University of Munster, Munster, Germany.
Campanacci
Laura
L
Gebert
Carsten
C
Picci
Piero
P
Gibbons
Max
M
Taylor
Richard
R
Hogendoorn
Pancras
P
Kroep
Judith
J
Wass
John
J
Athanasou
Nicholas
N
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
D000970:Antineoplastic Agents; D004164:Diphosphonates; D007093:Imidazoles; D000077211:Zoledronic Acid
Acta Orthop Scand. 1996 Jun;67(3):221-8
8686457
J Clin Pathol. 1990 Dec;43(12):997-1003
2266187
Sarcoma. 2003;7(1):35-41
18521367
J Bone Miner Res. 1997 Oct;12(10):1746-52
9333137
Clin Orthop Relat Res. 2000 Apr;(373):104-14
10810467
Skeletal Radiol. 2009 Jan;38(1):5-9
18649076
Am J Clin Oncol. 2006 Feb;29(1):96-9
16462511
Postgrad Med J. 2004 Apr;80(942):190-5
15082837
J Bone Joint Surg Am. 1999 Jun;81(6):811-20
10391546
Clin Orthop Relat Res. 2001 Jan;(382):6-12
11154006
J Dent Res. 2007 Nov;86(11):1022-33
17959891
Lab Invest. 1994 Oct;71(4):465-71
7526033
Orthop Clin North Am. 2006 Jan;37(1):35-51
16311110
Lancet Oncol. 2010 Mar;11(3):275-80
20149736
J Pediatr Hematol Oncol. 2001 Jan;23(1):54-6
11196272
Annu Rev Pharmacol Toxicol. 1998;38:375-88
9597160
J Pain Symptom Manage. 2009 Aug;38(2):244-57
19364633
Clin Orthop Relat Res. 2004 Sep;(426):103-9
15346059
Bone. 1996 Jan;18(1):9-14
8717530
Cancer. 2000 Jun 15;88(12 Suppl):2961-78
10898340
Hum Pathol. 2005 Sep;36(9):945-54
16153456
J Bone Joint Surg Am. 1987 Jan;69(1):106-14
3805057
Calcif Tissue Int. 2004 Jul;75(1):71-7
15037971
J Bone Miner Res. 1995 Oct;10(10):1478-87
8686503
J Med Assoc Thai. 2008 Oct;91(10):1609-12
18972907
Bone. 2008 Jan;42(1):68-73
17962092
Ultrastruct Pathol. 2003 Nov-Dec;27(6):385-91
14660277