Denosumab: A potential new treatment option for recurrent Aneurysmal Bone Cyst of the spine

Open Access

Table 1.

Published and current cases of Denosumab treatment of ABC.

	Case 1	Case 2	Case 3	Case 4	Case 5	Case 6	Case 7	Current case
Age/sex	8-year male	11-year male	5-year male	27-year male	26-year female	42-year male	16-year male	14-year female
Location	C5	C5	Sacrum	Sacrum	C7–T1	L5–S1	L5	D5
Diagnosis	Typical ABC	Typical ABC	Typical ABC	Typical ABC	Typical ABC	Aggressive ABC	Typical ABC	Typical ABC
Initial treatment	Surgery	Surgery	None	None	C4–T4 fixation, cervical laminectomy	Seven consecutive SAE	Five consecutive monthly SAEs	Surgery twice
Outcome of initial treatment	Recurrence at 1 month	Recurrence at 8 months	NA	NA	NA (adjuvant therapy)	Recurrence at 6 months, worsening radiculopathy	Pathologic vascularity after embolisation, right sciaticalgia	Recurrence at 2 months
Denosumab treatment	70 mg/m² sc monthly	70 mg/m² sc D1, 8, 15, 21, 28 and then monthly	1.2 mg/kg/dose sc D1, 8, 15, 21, 28 then monthly	Denosumab 120 mg sc D1, 8, 15, 28 and then monthly for 1 yr., followed by observation	120 mg sc monthly for 16 months	120 mg once a week for 4 weeks consecutively, then once every 40 days, 13 Denosumab administrations	120 mg once a week for 4 weeks consecutively, then once every 40 days, 11 Denosumab administrations	Denosumab 120 mg sc D1, 8, 15, 28 and then monthly for 6 months, followed by observation
Response to Denosumab	Recovery from neurological symptoms, and no progression of ABC, with evidence of bone formation on MRI at 2 months	Recovery from neurological symptoms, and no progression of ABC, with evidence of bone formation on MRI at 4 months	Resolution of pain and new bone formation with healing of pathologic fracture on MRI	Resolution of pain and new bone formation on CT scan, decrease in giant cells, and decrease in cellularity of fibrous stroma	Persistence of C8–T1 deficit, peripheral bone reconstruction, decrease in tumour size and bone fusion at 19.5 months follow-up	Complete ossification at 35 months CT scan. Pain-free	gradual mass reduction and progressive ossification since the 3rd month of administration. 33 months follow-up	Resolution of pain and new bone formation on MRI scan, complete recovery of neurologic worsening. No recurrence at 1.5 year follow-up
Follow-up	2 months	4 months	12 months	12 months	19.5 months	35 months	33 months	24 months
References	Lange et al. [6]	Lange et al. [6]	Pelle et al. [17]	Skubitz et al. [13]	Arnaud Dubory et al. [15]	Ghermandi et al. [14]	Ghermandi et al. [14]

Note: ABC indicates aneurysmal bone cyst; SAE, Selective Arterial Embolisation; NA, not applicable; CT, computed tomographic; MRI, magnetic resonance image; sc, sub-cutaneous.

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