How do you incorporate denosumab into the surgical management of giant cell tumor of bone?

Denosumab forever.

Giant cell tumors of bone have a clonal cancer component and then osteoclasts that are hypnotized by the cancer. Denosumab works on the osteoclasts so they quit listening to the cancer and then the whole thing turns to bone. Denosumab does not kill anything and the cancer cells ar...

The primary treatment of choice remains surgery (resection or curettage and packing per Ortho Onc). If not feasible or accompanied by significant associated morbidity, a trial of Denosumab would be very appropriate. Optimal duration of therapy is unknown, but reasonable to continue until maximum res...