A young adult has a recurrent giant cell tumour of the sacrum with extensive bony destruction. Resection would be morbid. Which agent, acting by inhibiting receptor activator of nuclear factor kappa-B ligand, is used to control unresectable or recurrent giant cell tumour of bone?
- A Teriparatide
- B Zoledronic acid
- C Denosumab ✓
- D Calcitonin
Correct answer: C. Denosumab
Explanation
Denosumab is a fully human monoclonal antibody against RANK ligand. By blocking RANKL-mediated osteoclast formation it arrests osteolysis and induces sclerosis in giant cell tumour, and it is indicated for unresectable, recurrent or metastatic disease where surgery would be mutilating. Bisphosphonates such as zoledronic acid are used as an adjuvant after curettage but are far less effective as sole systemic therapy. Teriparatide stimulates bone formation and calcitonin is obsolete here.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.