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MINI REVIEW article
Front. Endocrinol.
Sec. Pituitary Endocrinology
Volume 15 - 2024 |
doi: 10.3389/fendo.2024.1488958
This article is part of the Research Topic Advances and challenges in adult-onset craniopharyngioma View all articles
Practical Application of Precision Oncology in Adult Onset Craniopharyngiomas
Provisionally accepted- 1 Department of Neurological Surgery, Wexner Medical Center, The Ohio State University, Columbus, United States
- 2 Neurological Surgery, Wexner Medical Center, The Ohio State University, Columbus, United States
- 3 Department of Endocrinology, Wexner Medical Center, The Ohio State University, Columbus, United States
Introduction: Craniopharyngiomas (CPs) are benign and rare tumors found in adults. Their location close to vital neurovascular structures makes traditional treatment modalities (surgery and radiation) challenging and potentially fraught with morbidity. The 2021 WHO classification has divided what was previously considered two subtypes of craniopharyngioma into separate entities. Identification of specific molecular driver mutations in each type-BRAF V600E in papillary craniopharyngiomas (PCP) and CTNNB1 in adamantinomatous craniopharyngiomas (ACP) has resulted in a paradigm shift in the management of adult CPs.In this study, we describe our experience in treating PCPs with targeted therapy and highlight nuances in management accounting for current evidence. This review also explores the current scope and application of precision oncology in adult CPs including the experience with ongoing trials and prospects for future research.The high prevalence of targetable mutation in cases of PCP and the efficacy of BRAF inhibitors alone or in combination with MEK inhibitors has improved the disease control in these patients. In the current scenario, while surgery is warranted to obtain histopathological diagnosis, radical resection and its associated risks can be avoided. In case of ACPs, dysregulation of multiple pathways has been implicated. This has prompted the use of a variety of targeted therapies with inconsistent outcomes. The results of ongoing and future trials may define its role in management.
Keywords: targeted therapy, Craniopharyngioma, Papillary, Adamantinomatous, BRAF Chandrima Biswas: Writing-Original draft, Data curation Guilherme Mansur: Data Curation Kyle C. Wu: Writing-review and editing Daniel M. Prevedello: Writing-review and editing Luma Ghalib: Conceptualization, Writing-Review and Editing, supervision
Received: 31 Aug 2024; Accepted: 31 Oct 2024.
Copyright: © 2024 Biswas, Mansur, Wu, Prevedello and Ghalib. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Luma Ghalib, Department of Endocrinology, Wexner Medical Center, The Ohio State University, Columbus, United States
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