Denosumab administration for bone metastases from solid tumors: a retrospective cross-sectional study
Kohei Mizuta1, Hiromichi Oshiro1, Ryo Katsuki1
1Department of Orthopedic Surgery, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Okinawa, Japan.
BMC Cancer
|October 18, 2023
Summary
Denosumab may help prevent skeletal-related events (SREs) in patients with bone metastases. Higher SINS or Mirels' scores indicate increased SRE risk, even with denosumab treatment.
Area of Science:
- Oncology
- Orthopedics
- Pharmacology
Background:
- Limited understanding of denosumab's mechanism in reducing skeletal-related events (SREs) in solid tumor bone metastases.
- Need to evaluate denosumab's efficacy in preventing SREs and associated surgeries.
Purpose of the Study:
- To assess the effect of denosumab on SREs in patients with bone metastases from solid tumors.
- To compare SINS and Mirels' scores in patients with and without SREs to understand risk factors.
Main Methods:
- Retrospective analysis of 247 adult patients with metastatic bone lesions treated with denosumab.
- Evaluation of SREs, surgical interventions, Spinal Instability Neoplastic Score (SINS), and Mirels' score.
- Comparison of SINS and Mirels' scores between patients with and without SREs.
Main Results:
- SREs occurred in 7.7% of patients; 2 patients experienced SREs despite prior denosumab administration.
- Patients with SREs had significantly higher Mirels' scores (p<0.01) and higher SINS (p=0.09) compared to those without.
- Surgical interventions were performed in 5.7% of patients for spinal, intradural, or appendicular lesions.
Conclusions:
- Elevated SINS or Mirels' scores are associated with SRE occurrence in patients with bone metastases.
- Denosumab management requires careful consideration, as SREs can occur even with treatment.
- Surgical intervention may be necessary for patients presenting with high SINS or Mirels' scores.
