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Abstract
Denosumab is a game-changing drug for giant cell tumor of bone (GCTB); however, its clinical biomarker regarding tumor ossification of GCTB has not been elucidated. In this study, we investigated the relationship between Wnt/β-catenin signaling and the ossification of GCTB and evaluated whether endogenous nuclear β-catenin expression predicted denosumab-induced bone formation in GCTB. Genuine patient-derived primary GCTB tumor stromal cells exhibited osteoblastic characteristics. Identified osteoblastic markers and nuclear β-catenin translocation were significantly upregulated via differentiation induction and were inhibited by treating with Wnt signaling inhibitor, GGTI-286, or selective Rac1-LEF inhibitor, NSC23766. Furthermore, we reviewed the endogenous ossification and nuclear β-catenin translocation of 86 GCTB clinical samples and elucidated that intra-tumoral ossification was significantly associated with the nuclear translocation. Three-dimensional quantitative analyses (n = 13) of tumoral CT images have revealed that the nuclear β-catenin translocation of naïve GCTB samples was significantly involved with the denosumab-induced tumor ossification. Our findings suggest a close relationship between the nuclear β-catenin translocation and the osteoblastic differentiation of GCTB. Investigations of the nuclear β-catenin in naïve GCTB samples may provide a promising biomarker for predicting the ossification of GCTB following denosumab treatment.
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1 Kyushu University, Department of Orthopedic Surgery, Graduate School of Medical Sciences, Fukuoka City, Japan (GRID:grid.177174.3) (ISNI:0000 0001 2242 4849)
2 Kyushu University, Department of Anatomic Pathology, Pathological Sciences, Graduate School of Medical Sciences, Fukuoka, Japan (GRID:grid.177174.3) (ISNI:0000 0001 2242 4849)
3 National Hospital Organization Kyushu Medical Center, Department of Orthopedic Surgery, Fukuoka, Japan (GRID:grid.415613.4)
4 National Cancer Center, Department of Musculoskeletal Oncology and Rehabilitation, Tokyo, Japan (GRID:grid.272242.3) (ISNI:0000 0001 2168 5385)
5 Kyushu Rosai Hospital, Department of Orthopaedic Surgery, Fukuoka, Japan (GRID:grid.415645.7) (ISNI:0000 0004 0378 8112)