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Accreditation/ Credit Designation

Physicians’ Education Resource®, LLC, is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. These activites are not approved for AMA PRA Category 1 Credit™.

Acknowledgment of Commercial Support

This activity is supported by an educational grant from Daiichi Sankyo, Inc.


Oncology Briefings™: Updates in Therapeutic Options and Approaches for Tenosynovial Giant Cell Tumors PER Pulse™ Recap

PER Pulse Recap

PER Pulse™ Recap


Pathogenesis and Prevalence of TGCT

The online Oncology Briefings™ CME activity, Updates in Therapeutic Options and Approaches for Tenosynovial Giant Cell Tumors, provides oncologists and other healthcare professionals with an engaging presentation on the current and evolving treatment standards in tenosynovial giant cell tumors (TGCTs).

Leading expert William D. Tap, MD, medical oncologist and chief of the Sarcoma Medical Oncology Service at Memorial Sloan Kettering Cancer Center, New York, NY, answers key questions supported by the presentation of clinical science about TGCTs. This first of 3 PER Pulse™ Recaps from this program focuses on the pathology of TGCTs and their prevalence in patient populations.

Dr. Tap discussed the underlying genetic features of TGCTs, and provided his expert perspective on the disease’s prevalence and diagnosis. Key takeaways from Dr. Tap include:

  • Tenosynovial giant cell tumors are characterized by the presence of different cytogenetic rearrangements, including the translocation of the 1p11-13 region affecting the expression of CSF1, a tyrosine kinase receptor, and its ligand CSF1R, as well as the translocation of the 2q37 locus involving the COL6A3 gene.
  • Tenosynovial giant cell tumors are a fairly rare disease, with an incidence of 1.8 cases per million individuals. Dr. Tap expressed his concern that many people are simply unaware that they have TGCT, and remain untreated. Some estimations put the incidence rate as high as 49.7 cases per million.
  • Tenosynovial giant cell tumors can be difficult to properly diagnose due to their shared signs and symptoms with other, more common diseases. Dr. Tap posited that many patients are misdiagnosed with other rheumatological conditions, resulting in increased patient frustration and suffering.
  • Proper diagnosis of TGCT includes examination of histological features, including synovial hypertrophy with subsynovial mononuclear histiocytic reaction, as well as the presence of scattered giant cells and other specific signs. Immunohistochemical markers observed in TGCT include CD68, CD45, CD163, and CD681.

For additional information and commentary on this topic, as well as audio and supporting text, visit http://www.gotoper.com/online-cme-activities/oncology-briefing/oncology-briefings-updates-in-therapeutic-options-and-approaches-for-tenosynovial-giant-cell-tumors.

For information on other topics, visit www.gotoper.com.



2 of 3
PER Pulse™ Recap

Current Treatment and Management Strategies in TGCT

The online Oncology Briefings™ CME activity, Updates in Therapeutic Options and Approaches for Tenosynovial Giant Cell Tumors, provides oncologists and other healthcare professionals with an engaging presentation on the current and evolving treatment standards in tenosynovial giant cell tumors (TGCTs).

Leading expert William D. Tap, MD, medical oncologist and chief of the Sarcoma Medical Oncology Service at Memorial Sloan Kettering Cancer Center, New York, NY, answers key questions supported by the presentation of clinical science about TGCT. This second of 3 PER Pulse™ Recaps from this program focuses on the treatment and management strategies considered standard in the field of TGCT.

Dr. Tap elaborated on the standard treatment options and outcomes for TGCT, depending on their location, as well as the role of radiotherapy in treating TGCT. Key takeaways from Dr. Tap include:

  • The recurrence rate for TGCT after treatment may be as high as 50%, and the disease is considered difficult to cure with the passage of time. Treatment for TGCT varies on the location of the tumor, and options are limited due to lack of specific clinical data.
  • Surgery is considered the gold standard of treatment for TGCT. Synovectomy may be either partial or complete, and while both arthroscopic surgery and open surgical excision may be performed, a decreased recurrence rate has been reported with the more invasive, open surgical excision.
  • Dr. Tap expanded on some controversy surrounding the use of radiation in conjunction with synovectomy, specifically the use of 90-Yttrium-labelled colloid. Although the relapse rate for TGCT with radiosynovectomy is 30% for tumors of the knee and significantly lower for tumors of other locations, potential for secondary disease is a risk that many physicians do not take.

For additional information and commentary on this topic, as well as audio and supporting text, visit http://www.gotoper.com/online-cme-activities/oncology-briefing/oncology-briefings-updates-in-therapeutic-options-and-approaches-for-tenosynovial-giant-cell-tumors.

For information on other topics, visit www.gotoper.com.


3 of 3
PER Pulse™ Recap

Emerging Treatment and Management Strategies in TGCT

The online Oncology Briefings™ CME activity, Updates in Therapeutic Options and Approaches for Tenosynovial Giant Cell Tumors, provides oncologists and other healthcare professionals with an engaging presentation on the current and evolving treatment standards in tenosynovial giant cell tumors (TGCTs).

Leading expert William D. Tap, MD, medical oncologist and chief of the Sarcoma Medical Oncology Service at Memorial Sloan Kettering Cancer Center, New York, NY, answers key questions supported by the presentation of clinical science about TGCT. This third and final PER Pulse™ Recap from this program focuses on the emerging treatment and management strategies in the field of TGCT.

Dr. Tap detailed emerging treatment options for patients with TGCT, including immunotherapy and systemic targeted therapy options. The importance of a multidisciplinary team was also stressed. Key takeaways from Dr. Tap include:

  • The biology of TGCT has been increasingly understood, resulting in rational drug design and development. Macrophages and inflammatory cytokines, such as TNF-α, have been found in the synovium of affected patients. As such, immunotherapy treatments with TNF-α‒blocking agents are being investigated.
  • Systemic targeted therapy of the CSF1-CSF1R axis is also being investigated. Imatinib has been reported to block CSF1R activation. In affected patients, it almost universally reduced pain. Further, nearly three-quarters of patients had stable disease, and almost 5% reached complete remission under imatinib treatment.
  • Pexidartinib, an oral inhibitor of CSF1R, has shown response or stable disease in over 80% of patients and an overall response rate more than double that of imatinib in separate studies. Dr. Tap expressed the anticipation within the field of the results from the phase 3 ENLIVEN study investigating this agent. Other targeted drugs under investigation include nilotinib and emactuzumab.

For additional information and commentary on this topic, as well as audio and supporting text, visit http://www.gotoper.com/online-cme-activities/oncology-briefing/oncology-briefings-updates-in-therapeutic-options-and-approaches-for-tenosynovial-giant-cell-tumors.

For information on other topics, visit www.gotoper.com.





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