地诺单抗治疗骨转移疗效怎么样呢？

Binds to RANKL, a transmembrane or soluble protein that plays an important role in the formation, function, and survival of osteoclasts, the cells responsible for bone resorption, and regulates the release of calcium from bone.

Through RANKL stimulation, osteoclast activity is enhanced, mediating the occurrence of bone metastasis bone pathology in solid tumors. In addition, giant cell tumors of bone contain stromal cells that express RANKL, and osteoclast-like giant cells express RANKL receptors, which signal to each other leading to osteolysis and tumor growth.

Denosumab prevents RANKL from activating its receptor RANK expressed on the surface of osteoclasts, precursor cells, and osteoclast-like giant cells.

So, how effective is denosumab in treating bone metastases?

The therapeutic effect of denosumab in the treatment of bone metastases:

1. In phase II clinical trials, 86% (30/35) of patients with unresectable or recurrent GCTB treated with denosumab experienced tumor efficacy (defined as at least 90% disappearance of giant cells or no impact on tumor progression of target lesions for 25 weeks).

2. In the phase II clinical trial, 282 patients were divided into 3 groups. Group 1 was patients with unresectable GCTB, group 2 was patients with postoperative GCTB with severe surgical complications, and group 3 was patients who had previously been studied using denosumab. In group 1, 96% of patients showed no progression after 13 months of follow-up, in group 2, 74% of patients did not undergo surgery after 9.2 months of follow-up, and 62% of patients underwent surgery with fewer complications. The pain was significantly reduced after 2 months of use.

Use of denosumab in special populations:

1. Breastfeeding mothers: You should choose to stop taking the medicine or stop breastfeeding.

2. Children: It is recommended that this drug be used only in adolescent patients with giant cell tumor of bone who have mature bones.

3. Patients with renal impairment: Patients whose creatinine clearance is less than 30ml/min or who undergo renal dialysis are at higher risk of hypocalcemia. Calcium and vitamin D should be appropriately supplemented during medication.

Contraindications: Contraindicated in patients with hypocalcemia and hypersensitivity to denosumab.