Machak GN, Bruland ØS, Kovalev AV, Rodionova SS. Rethinking the role of bisphosphonates after denosumab treatment in locally advanced or unresectable aneurysmal bone cysts: A meta-analysis. World J Orthop 2025; 16(8): 107083 [DOI: 10.5312/wjo.v16.i8.107083]
Corresponding Author of This Article
Gennady N Machak, MD, PhD, Clinical and Diagnostic Center, FSBI “National Medical Research Center for Traumatology and Orthopedics named after N.N. Priorov” of the Ministry of Health of the Russian Federation, 10 Priorova Street, Moscow 127299, Russia. machak.gennady@mail.ru
Research Domain of This Article
Oncology
Article-Type of This Article
Meta-Analysis
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Orthop. Aug 18, 2025; 16(8): 107083 Published online Aug 18, 2025. doi: 10.5312/wjo.v16.i8.107083
Rethinking the role of bisphosphonates after denosumab treatment in locally advanced or unresectable aneurysmal bone cysts: A meta-analysis
Gennady N Machak, Øyvind S Bruland, Alexey V Kovalev, Svetlana S Rodionova
Gennady N Machak, Clinical and Diagnostic Center, FSBI “National Medical Research Center for Traumatology and Orthopedics named after N.N. Priorov” of the Ministry of Health of the Russian Federation, Moscow 127299, Russia
Øyvind S Bruland, Department of Oncology, Norwegian Radium Hospital, Oslo University Hospital, Oslo N-0310, Norway
Alexey V Kovalev, Laboratory of Cell Technologies and Medical Genetics, FSBI “National Medical Research Center for Traumatology and Orthopedics named after N.N. Priorov” of the Ministry of Health of the Russian Federation, Moscow 127299, Russia
Svetlana S Rodionova, Center of Osteoporosis, National Medical Research Center of Traumatology and Orthopedics named after N.N. Priorov, Moscow 127299, Russia
Co-first authors: Gennady N Machak and Øyvind S Bruland.
Author contributions: All authors contributed to the study conception and design. Machak GN designed the research study; material preparation, data collection, and analysis were performed by Machak GN, Bruland ØS, Kovalev AV, and Rodionova SS; the first draft of the manuscript was written by Machak GN and all authors commented on previous versions of the manuscript; all authors have read and approved the final manuscript.
Conflict-of-interest statement: The authors declare that they have no known competing financial, political, intellectual and religious interests or personal relationships that could have appeared to influence the work reported in this paper.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Gennady N Machak, MD, PhD, Clinical and Diagnostic Center, FSBI “National Medical Research Center for Traumatology and Orthopedics named after N.N. Priorov” of the Ministry of Health of the Russian Federation, 10 Priorova Street, Moscow 127299, Russia. machak.gennady@mail.ru
Received: March 16, 2025 Revised: May 5, 2025 Accepted: July 23, 2025 Published online: August 18, 2025 Processing time: 146 Days and 21.8 Hours
Core Tip
Core Tip: Benign bone tumors containing giant cells undergo significant ossification after denosumab treatment. In these conditions, sequentially administered bisphosphonates (BPs) accumulate better in newly formed bone, which may lead to long-term local control, presumably due to a pro-apoptotic effect on residual tumor cells. In this context, we studied a group of patients with inoperable aneurysmal bone cysts (ABCs) who were treated with denosumab and found that among those patients who received BPs for post-denosumab rebound hypercalcemia, there were no local relapses. We assume that BPs could have the same irreversible effect on residual tumor cells in ABCs and propose to continue experimental and prospective clinical studies to confirm this hypothesis.
