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Denosumab, sold under the brand name Prolia® or Xgeva®, , works by inhibiting a protein called RANKL (receptor activator of nuclear factor kappa-B ligand). RANKL plays a crucial role in bone metabolism by promoting the formation, activity, and survival of osteoclasts, which are cells responsible for breaking down bone tissue. By blocking RANKL, denosumab inhibits osteoclast function and reduces bone resorption. It has been used to help shrink cancer tumor, alleviate symptoms such as pain, and potentially make surgical removal easier by decreasing the size of the tumor and its aggressiveness. It may also be used as adjuvant therapy after surgery to prevent recurrence.