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Measurement of bone mineral density as an efficacy marker in denosumab treatment of giant cell tumour of bone
  1. Christian Veng1,
  2. Peter Holmberg Jørgensen2,
  3. Inger Krog-Mikkelsen2,
  4. Maiken Stilling1
  1. 1Department of Orthopedic Surgery, Holstebro Regionshospital, Holstebro, Region Midtjylland, Denmark
  2. 2Department of Orthopedic Surgery, Aarhus Universitetshospital, Aarhus, Region Midtjylland, Denmark
  1. Correspondence to Christian Veng, ajaxveng{at}


Three patients with giant cell tumour of bone (GCTB) in the lower extremity, where the only surgical treatment options were amputation or severe weakening of the bone, were treated with denosumab (D-mab) to strengthen the bone mass in the tumour. In order to quantify changes in bone mineral density (BMD) in the GCTB lesion during D-mab treatment, we did repeated dual-energy X-ray absorptiometry (DXA) scans. The patients underwent operation after 3, 4 and 8 months of D-mab treatment, respectively. The tumours in all three patients responded markedly to D-mab, and up to 50% BMD increase was observed. There was almost no BMD change in the control scans in the hip and spine of the same patients. DXA scans provide no information about local tumour response, but may be of value in evaluation of the time and size of the D-mab response in GCTB, and thereby aid in finding the best timing for surgery.

  • Musculoskeletal And Joint Disorders
  • Drug Therapy Related To Surgery
  • Orthopaedics
  • Cancer
  • Orthopaedic And Trauma Surgery
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  • Contributors PHJ, IKM and MS set up the treatment and follow-up regime. IKM completed the DXA scans. CV and MS analysed the data. CV wrote the article, and MS, PHJ and IKM revised the article. All four authors approved the final version and agreed to be accountable for the article and have ensured that all questions regarding the accuracy or integrity of the article are investigated and resolved.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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