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Local Bisphosphonate Effect on Recurrence Rate in Extremity Giant Cell Tumor of Bone

Phase 3
Recruiting
Conditions
Giant Cell Tumor of Bone
Interventions
Registration Number
NCT03295981
Lead Sponsor
St. Louis University
Brief Summary

The purpose of the clinical study is to investigate whether the local delivery of bisphosphonate as a surgical adjuvant can decrease the chance of a giant cell tumor of bone coming back to the same location. The hypothesis is that the local administration of bisphosphonate will decrease the rate of the tumor returning compared to traditional aggressive surgical removal of the tumor.

Detailed Description

The purpose of the clinical study is to investigate whether the local delivery of bisphosphonate (BP-loaded PMMA bone cement) as a surgical adjuvant can decrease the local recurrence rate of giant cell tumor (GCT) of bone. The investigators will evaluate whether bisphosphonate as a surgical adjuvant improves secondary outcomes, such as pain, function, fever, or wound complications. The hypothesis is that the local administration of bisphosphonate will decrease the recurrence rate of GCT compared to traditional aggressive intralesional curettage.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
120
Inclusion Criteria
  • Primary benign GCT of bone
  • Lesion located in an extremity
  • Lesion amenable to reconstruction (intralesional curettage) defined as having at least one intact column of bone after removal
  • No previous systemic bisphosphonate or denosumab therapy
Exclusion Criteria
  • Recurrent GCT of bone
  • Non-extremity location
  • Lesion too extensive for intralesional treatment, either due to bone loss, joint invasion, or large soft tissue component
  • Children and pregnancy
  • Previous systemic bisphosphonate or denosumab therapy

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Bisphosphonate groupZoledronic AcidIn Arm 2, the bisphosphonate group, 4 mg of zoledronic acid (Zometa) will be added to each bag of bone cement.
Primary Outcome Measures
NameTimeMethod
The endpoint for patient participation will be local recurrenceFollowed for 2 years postoperatively for study end points

Local recurrence of giant cell tumor of bone

Secondary Outcome Measures
NameTimeMethod
Surgical site infectionFollow-ups will consist of clinical visits. The clinical visits will be at 2 weeks postoperatively, 6 weeks postoperatively, and then every three months for the first two years after surgery.

The surgical site will be assessed for a surgical site infection (SSI) as defined by CDC guidelines after surgery and during scheduled follow-up as outlined in time frame below.

Wound healingFollow-ups will consist of clinical visits. The clinical visits will be at 2 weeks postoperatively, 6 weeks postoperatively, and then every three months for the first two years after surgery.

The surgical site will be assessed after surgery and during scheduled follow-up as outlined in time frame below for wound healing issues/concerns.

MSTS ScoreFollowed for 2 years postoperatively for study end points

The Musculoskeletal Tumor Society (MSTS) scoring system is a validated and well-accepted functional scoring system used in orthopaedic oncology research

Potential bisphosphonate complications related to systemic administrationFollowed for 2 years postoperatively for study end points

Patients will be followed for atypical femur fractures and avascular necrosis (AVN) of jaw

Trial Locations

Locations (16)

University of Washington

🇺🇸

Seattle, Washington, United States

University of California - Los Angeles

🇺🇸

Los Angeles, California, United States

Indiana University

🇺🇸

Indianapolis, Indiana, United States

University of Iowa

🇺🇸

Iowa City, Iowa, United States

University of Kansas

🇺🇸

Overland Park, Kansas, United States

Johns Hopkins University Hospital

🇺🇸

Baltimore, Maryland, United States

Massachusetts General Hospital

🇺🇸

Boston, Massachusetts, United States

Boston Children's Hospital

🇺🇸

Boston, Massachusetts, United States

Beth Israel Deaconess Medical Center

🇺🇸

Boston, Massachusetts, United States

Saint Louis University

🇺🇸

Saint Louis, Missouri, United States

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University of Washington
🇺🇸Seattle, Washington, United States
Roxanne Moore
Contact
romoore@fredhutch.org
Elyse Brinkmann, MD
Contact
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