Aneurysmal bone cysts therapy using monoclonal human antibodies to RANKL

Aneurysmal bone cyst is a rare, locally destructive, benign neoplasm with a predominant localization in the bones. Aneurysmal bone cyst accounts for 1%–6% of primary bone tumors, and 80% of these lesions occur in the second decade of life with a slight prevalence in the female population. Currently, the optimal aneurysmal bone cyst treatment remains unclear. There are various treatment methods, each of which has its own indications, advantages, and disadvantages. The study of the key pathogenetic foundations of the process indicates the introduction of targeted aneurysmal bone cyst therapy. This study presents the systematized classification and description of the disease pathogenesis regarded from molecular and genetic viewpoints. The mechanism of targeted therapy based on the use of monoclonal human antibodies to RANKL has been studied. Articles published in 2012–2023 (July) were considered. Consequently, conclusions concerning the most common aneurysmal bone cyst localizations, patient’s age and sex, dosage regimen, treatment result, and possible complications during the therapy have been made. Thus, denosumab has therapeutic advantages regarding clinical and radiological results in patients with aneurysmal bone cyst. Closely relevant is the issue of using denosumab in the treatment of patients with aneurysmal bone cyst of complex anatomical localization and in cases of aggressive recurrence of the pathological process.