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CASE REPORT article

Front. Oncol.
Sec. Neuro-Oncology and Neurosurgical Oncology
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1464362
This article is part of the Research Topic Advances in Brain Tumor Therapy View all 8 articles

Clinical Response to Dabrafenib Plus Trametinib in BRAF V600E Mutated Papillary Craniopharyngiomas: A Case Report and Literature Review

Provisionally accepted
PauL Hanona PauL Hanona *Daniel Ezekwudo Daniel Ezekwudo Joseph Anderson Joseph Anderson
  • Beaumont Hospital, Beaumont Health, Royal Oak, United States

The final, formatted version of the article will be published soon.

    Papillary craniopharyngiomas are rare tumors prevalent to the precision oncology world due to their high rate of BRAF V600E mutations. Symptoms include vision loss, neuroendocrine dysfunction, and cognitive dysfunction. Treatment involves an interdisciplinary approach with surgery, radiation, and systemic treatment. Recent attention has been directed towards targeted therapy in this space, especially with targets to the BRAF V600E mutated pathway. Focusing on this pathway could solidify future standards of care treatment. A 61-year-old male came in with bilateral homonymous hemianopsia. This prompted a brain MRI that showed a bilobed centrally cystic peripherally enhancing sellar and suprasellar mass with mass effect on the left greater than right optic chiasm and nerves. He underwent a primary resection of the suprasellar cystic tumor, and it was revealed that he had papillary craniopharyngioma. Three months later he represented with visual defects and repeat MRI showed cystic recurrence with compression of the optic chiasm. He underwent an endonasal resection of the middle fossa tumor, pathology this time showed a BRAF V600E mutated papillary craniopharyngioma. Nine months later another recurrence happened, and the patient was started on BRAF and MEK inhibitors: dabrafenib (75mg BID) and trametinib (2mg daily). The patient has had clinical improvement of visual symptoms and is currently continuing this treatment. He was last seen October of 2024 and he is clinically stable. The use of targeted therapies is an evolving space for BRAF V600E mutated papillary craniopharyngiomas. This is a case showing improvement of a craniopharyngioma after treatment with BRAF and MEK inhibitor combinations. The role of BRAF and MEK inhibitor combinations continues to evolve in this space.

    Keywords: Papillary, Craniopharyngioma, BRAF mutation V600E, dabrafenib, trametinib

    Received: 13 Jul 2024; Accepted: 21 Oct 2024.

    Copyright: © 2024 Hanona, Ezekwudo and Anderson. 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: PauL Hanona, Beaumont Hospital, Beaumont Health, Royal Oak, United States

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