地舒单抗是治疗什么的

Bone metastasis is a common phenomenon in the late stages of tumors. Studies have shown that almost all solid tumors have a chance of transforming into bone metastasis, such as lung cancer, breast cancer, gastrointestinal cancer, prostate cancer, kidney cancer, thyroid cancer, etc. The process of tumor bone metastasis may cause pathological fractures, spinal cord compression, pain, hypercalcemia and other symptoms. At present, the drug commonly used in China to treat tumor bone metastasis is zoledronic acid, but according to multiple clinical studies, the efficacy of denosumab is significantly better than that of zoledronic acid in patients with solid tumor bone metastasis.

Denosumab is the first approved monoclonal antibody agent that specifically targets RANK ligand. A transmembrane or soluble protein necessary for osteoclasts to maintain their structure, function and survival is RANK ligand. The main role of human RANKL mRNA in lymphoid tissue, bone, and bone marrow in bone is to stimulate the differentiation and activity of osteoclasts, thereby inhibiting osteoclast apoptosis. Osteoclasts are mainly responsible for bone resorption. The prerequisite for osteoclast precursors to differentiate into mature osteoclasts is the presence of low levels of macrophage colony-stimulating factor and RANKL. Denosumab has a high affinity with RANKL and can prevent RANK ligands from activating RANK on the surface of osteoclasts, thereby inhibiting osteoclast activation and development, increasing bone density and bone strength of both cortical bone and trabecular bone, and promoting bone reconstruction. The size of the tumor can be well reduced and reduced by denosumab, thereby inhibiting bone destruction and blocking the development of pathology. Therefore, the earliest indication was approved for the treatment of unresectable giant cell tumor of bone. Because the reduced size inhibits osteoclastosis and is accompanied by new bone formation, the tumor becomes smaller and the boundaries become clearer, creating conditions for a second surgery to turn unresectable into resectable. Therefore, denosumab is used in some cases for preoperative neoadjuvant treatment of giant cell tumor of bone, thereby achieving the purpose of surgical downstaging.