Abraham J - Denosumab is a human monoclonal antibody to the receptor activator of nuclear factor-kappaB ligand (RANKL). RANKL is an important mediator of osteoclast differentiation, function, and survival and plays a central role in bone destruction related to metastatic cancer. For prevention and treatment of bone metastasis, the doses being used in clinical trials range from 30 to 180 mg SC at a frequency of anywhere from every 4 weeks to every 6 months. Overall, denosumab is a well-tolerated drug, but its long-term effects have not been completely characterized. Once denosumab is approved by the US Food and Drug Administration, its cost will be such that it can compete favorably with the cost of IV bisphosphonate therapy and not be an excessive financial burden on the patients who would likely benefit from it.
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