1f0537509e4f8720dbe5b989ac7a6432 322733.pdf 0c28aeffdb505d2a2aec8eb49cb54f920edc36b6 322733.pdf 141bd49338c9fb9e5d904e2223f3d27f38005d59d8c00fc595fd07a5a27b809b 322733.pdf Title: A Multicenter Study by the DENO Research Group on the Use of Denosumab in Giant-Cell Tumors of the Bone Subject: Background/Objectives: Despite the therapeutic potential of denosumab for the treatment of giant-cell tumors of the bone (GCTBs), there is a lack of standardization in treatment protocols. Methods: We present a multicenter, retrospective, descriptive study conducted across the seven hospitals in Spain affiliated with the DENO Research Group. Seventy-three patients diagnosed with GCTB and treated with denosumab were included and stratified according to treatment strategy—neoadjuvant (n = 38), adjuvant (n = 8), and single treatment (n = 27). Results: Patients in the neoadjuvant group received denosumab for a median of 6.1 months, with reintroduction after surgery in 25.8% of all cases. Among the neoadjuvant patients treated with curettage, recurrence was 35.5%, with no association with denosumab treatment duration (p = 0.274) nor with denosumab reintroduction after surgery (p = 0.405). In the adjuvant group, those who completed treatment received denosumab for 15.3 months, while those still undergoing therapy received it for a median of 12.8 months; only one case (12.5%) recurred. Recurrence rates in neoadjuvant and adjuvant treatment strategies were not different (p = 0.394). Patients treated only with denosumab and no longer on treatment had received it for 34.2 months, with 31.3% recurrence; those still on treatment had received it for 51.8 months, with 25.0% recurrence. Across all strategies, more than 85% of patients reported favorable clinical outcomes, and only 43.8% presented adverse events. No deaths occurred during this study. Conclusions: Although patients who experienced recurrence during neoadjuvant treatment had longer durations of denosumab administration, the difference was not statistically significant. Similarly, recurrence rates did not differ significantly, whether denosumab was reintroduced after surgery or not. Among the patients treated with curettage, recurrence rates were comparable between neoadjuvant and adjuvant strategies. Discontinuation of the single treatment did not necessarily result in disease progression. +5pt Keywords: giant-cell tumors of the bone; denosumab; neoadjuvant; adjuvant; single treatment Author: DENO Research Group, Carolina de la Calva, Manuel Angulo, Paula González-Rojo, Ana Peiró, Pau Machado, Juan Luis Cebrián, Roberto García-Maroto, Antonio Valcárcel, Pablo Puertas, Gregorio Valero-Cifuentes, Óscar Pablos, Miriam Maireles, María Luisa Fontalva, Iván Chaves, Aida Orce, Luis Coll-Mesa, Israel Pérez, Fausto González, María del Carmen Sanz and Isidro Gracia Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25 CreationDate: Wed May 7 11:44:50 2025 CEST ModDate: Wed May 7 11:50:17 2025 CEST Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 13 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 453544 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- XYXRRC+VnURWPalladioL-Bold Type 1 Custom yes yes yes 10 0 BVWPJH+VnURWPalladioL Type 1 Custom yes yes yes 16 0 WBDBMI+URWPalladioL-Roma Type 1 Custom yes yes yes 21 0 JVJBXV+URWPalladioL-Bold Type 1 Custom yes yes yes 27 0 AUKOFI+URWPalladioL-Ital Type 1 Custom yes yes yes 32 0 LGTZLE+CMSY10 Type 1 Builtin yes yes yes 61 0 JTLVXF+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 79 0 FVLSTN+PalatinoLinotype-Italic TrueType WinAnsi yes yes yes 87 0 VLPPJH+PalatinoLinotype-Bold TrueType WinAnsi yes yes yes 91 0 ADATBX+PalatinoLinotype-Roman TrueType WinAnsi yes yes yes 95 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2026-01-28 04:14:04 CET RepresentationInformation: 322733.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2026-01-27 10:53:39 CET Size: 453544 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 277 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Materials and Methods Destination: section.2 Item: Title: Results Destination: section.3 Children: Item: Title: Neoadjuvant Treatment Destination: subsection.3.1 Item: Title: Adjuvant Treatment Destination: subsection.3.2 Item: Title: Recurrence in Curettage: Neoadjuvant vs. Adjuvant Treatment Destination: subsection.3.3 Item: Title: Single Treatment Destination: subsection.3.4 Item: Title: Toxicity Destination: subsection.3.5 Item: Title: Discussion Destination: section.4 Children: Item: Title: Treatment of GCTB with Denosumab Destination: subsection.4.1 Item: Title: Neoadjuvant Treatment Destination: subsection.4.2 Item: Title: Adjuvant Treatment Destination: subsection.4.3 Item: Title: Single-Treatment Destination: subsection.4.4 Item: Title: Toxicity Destination: subsection.4.5 Item: Title: Limitations of This Study Destination: subsection.4.6 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: section.6 Info: Title: A Multicenter Study by the DENO Research Group on the Use of Denosumab in Giant-Cell Tumors of the Bone Author: DENO Research Group, Carolina de la Calva, Manuel Angulo, Paula González-Rojo, Ana Peiró, Pau Machado, Juan Luis Cebrián, Roberto García-Maroto, Antonio Valcárcel, Pablo Puertas, Gregorio Valero-Cifuentes, Óscar Pablos, Miriam Maireles, María Luisa Fontalva, Iván Chaves, Aida Orce, Luis Coll-Mesa, Israel Pérez, Fausto González, María del Carmen Sanz and Isidro Gracia Subject: Background/Objectives: Despite the therapeutic potential of denosumab for the treatment of giant-cell tumors of the bone (GCTBs), there is a lack of standardization in treatment protocols. Methods: We present a multicenter, retrospective, descriptive study conducted across the seven hospitals in Spain affiliated with the DENO Research Group. Seventy-three patients diagnosed with GCTB and treated with denosumab were included and stratified according to treatment strategy neoadjuvant (n = 38), adjuvant (n = 8), and single treatment (n = 27). Results: Patients in the neoadjuvant group received denosumab for a median of 6.1 months, with reintroduction after surgery in 25.8% of all cases. Among the neoadjuvant patients treated with curettage, recurrence was 35.5%, with no association with denosumab treatment duration (p = 0.274) nor with denosumab reintroduction after surgery (p = 0.405). In the adjuvant group, those who completed treatment received denosumab for 15.3 months, while those still undergoing therapy received it for a median of 12.8 months; only one case (12.5%) recurred. Recurrence rates in neoadjuvant and adjuvant treatment strategies were not different (p = 0.394). Patients treated only with denosumab and no longer on treatment had received it for 34.2 months, with 31.3% recurrence; those still on treatment had received it for 51.8 months, with 25.0% recurrence. Across all strategies, more than 85% of patients reported favorable clinical outcomes, and only 43.8% presented adverse events. No deaths occurred during this study. Conclusions: Although patients who experienced recurrence during neoadjuvant treatment had longer durations of denosumab administration, the difference was not statistically significant. Similarly, recurrence rates did not differ significantly, whether denosumab was reintroduced after surgery or not. Among the patients treated with curettage, recurrence rates were comparable between neoadjuvant and adjuvant strategies. 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