title: RANKL, denosumab, and giant cell tumor of bone.
abstract: OBJECTIVE
  Giant cell tumor (GCT) of bone is a benign, osteolytic neoplasm of bone. The receptor activator of NF-KB ligand (RANKL) pathway has recently been shown to play a key role in the pathogenesis of GCT.
  
  
  RESULTS
  Treatment for refractory, recurrent, or metastatic GCT remains challenging. The recent development of a monoclonal antibody to RANKL, denosumab, offers promise in the management of these patients. A recent phase 2 study suggested denosumab offers disease and symptom control for patients with advanced or refractory disease. In this population, denosumab appears to be well tolerated. There are key questions which remain to be addressed, including patient selection, optimal scheduling, use as an adjuvant, and application to other giant cell-rich disorders.
  
  
  CONCLUSIONS
  Denosumab offers a new treatment option for a subset of patients with previously untreatable GCT. The role of denosumab in curative treatment is the subject of ongoing studies.
authors.affiliation: Department of Cancer Medicine, Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia. david.thomas@petermac.org
authors.forename: David M
authors.initials: DM
authors.lastname: Thomas
mesh_terms: D000818:Animals; D000911:Antibodies, Monoclonal / Q000276:immunology / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents / Q000276:immunology / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000188:drug therapy* / Q000276:immunology / Q000378:metabolism; D000069448:Denosumab; D018212:Giant Cell Tumor of Bone / Q000188:drug therapy* / Q000276:immunology / Q000378:metabolism; D006801:Humans; D053245:RANK Ligand / Q000037:antagonists & inhibitors* / Q000276:immunology / Q000378:metabolism
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D053245:RANK Ligand; D000069448:Denosumab