Tenosynovial giant cell tumour (TGCT)
Prepared with OnCo (onco.cc/prep/tenosynovial-giant-cell-tumour/). Orientation, not medical advice; your team knows your case.
My details
What I know, what is unclear, changes to discuss
Saved in this browserMy questions
14 on the sheet- 1.What is my exact diagnosis, stage, and grade, and which tests established them?
- 2.Which biomarkers have been tested on my tumour (for example CSF1 rearrangementin neoplastic cells, CSF1R-positive macrophage-rich infiltrate, MRI pattern, Liver function tests before and during pexidartinib), and what were the results?
- 3.Which subtype is my cancer, and does that change the recommended treatment?
- 4.Is germline (inherited) genetic testing recommended for me or my family?
- 5.For my situation (localised tgct), which of the standard options do you recommend and why?
- 6.For my situation (diffuse tgct, resectable), which of the standard options do you recommend and why?
- 7.For my situation (diffuse tgct where surgery would cause severe morbidity or after recurrence), which of the standard options do you recommend and why?
- 8.Am I a candidate for Vimseltinib, Pexidartinib, Imatinib or related drugs, and what side effects should I expect?
- 9.How do the results of MOTION apply to someone like me?
- 10.Are there clinical trials I could join, for example of Vimseltinib, MOTION, Emactuzumab, Pimicotinib?
- 11.Would a second opinion at a high-volume centre change anything, and can you help arrange it?
- 12.What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?
- 13.I read that “Duration of CSF1R therapy and rebound after stopping: extension cohorts and intermittent schedules are being studied”. How does that affect my plan?
- 14.I read that “Hepatotoxicity of pexidartinib: newer agents (vimseltinib, emactuzumab) are designed to avoid it”. How does that affect my plan?
The words I may hear
- Rare cancers: Rare cancers are those with fewer than about 6 new cases per 100,000 people per year.
Tests and results to bring
Biomarker results to ask for: CSF1 rearrangement (COL6A3-CSF1) in neoplastic cells, CSF1R-positive macrophage-rich infiltrate, MRI pattern (haemosiderin blooming on gradient echo), Liver function tests before and during pexidartinib (REMS).
Scans and tests linked to this cancer: MRI.
Bring copies of scan reports, pathology and blood results, and a list of every medicine and supplement.
The treatments I may be offered
- Localised TGCT: Marginal excision; recurrence is uncommon and re-excision is curative in most cases. (Limb-salvage surgery and endoprosthetic reconstruction)
- Diffuse TGCT, resectable: Open or arthroscopic synovectomy by a sarcoma orthopaedic team; consider neoadjuvant CSF1R inhibition for large tumours (trial setting). (Limb-salvage surgery and endoprosthetic reconstruction)
- Diffuse TGCT where surgery would cause severe morbidity or after recurrence: CSF1R inhibitor: vimseltinib (MOTION) or pexidartinib (ENLIVEN, with REMS hepatic monitoring); imatinib or nilotinib off label where neither is available. (Vimseltinib, Pexidartinib, MOTION, Imatinib, Nilotinib)
From the standard of care recorded for this cancer; which apply depends on your stage and biomarkers. Ask which the team recommends and why.