Blakeley Jaishri O, Plotkin Scott R
Neurology, Neurosurgery and Oncology, Johns Hopkins University, Baltimore, MD (J.O.B.); Neurology, Harvard Medical School, Stephen E. and Catherine Pappas Center for Neuro-Oncology, Massachusetts General Hospital, Boston, MA (S.R.P.).
Neuro Oncol. 2016 May;18(5):624-38. doi: 10.1093/neuonc/nov200. Epub 2016 Feb 6.
Neurofibromatosis type 1 (NF1), neurofibromatosis type 2 (NF2), and schwannomatosis (SWN) are tumor-suppressor syndromes. Each syndrome is an orphan disease; however, the tumors that arise within them represent the most common tumors of the nervous system worldwide. Systematic investigation of the pathways impacted by the loss of function of neurofibromin (encoded byNF1) and merlin (encoded byNF2) have led to therapeutic advances for patients with NF1 and NF2. In the syndrome of SWN, the genetic landscape is more complex, with 2 known causative genes (SMARCB1andLZTR1) accounting for up to 50% of familial SWN patients. The understanding of the molecular underpinnings of these syndromes is developing rapidly and offers more therapeutic options for the patients. In addition, common sporadic cancers harbor somatic alterations inNF1(ie, glioblastoma, breast cancer, melanoma),NF2(ie, meningioma, mesothelioma) andSMARCB1(ie, atypical teratoid/rhabdoid tumors) such that advances in management of syndromic tumors may benefit patients both with and without germline mutations. In this review, we discuss the clinical and genetic features of NF1, NF2 and SWN, the therapeutic advances for the tumors that arise within these syndromes and the interaction between these rare tumor syndromes and the common tumors that share these mutations.
1型神经纤维瘤病(NF1)、2型神经纤维瘤病(NF2)和神经鞘瘤病(SWN)是肿瘤抑制综合征。每种综合征都是一种罕见病;然而,这些综合征中出现的肿瘤却是全球最常见的神经系统肿瘤。对由神经纤维瘤蛋白(由NF1编码)和默林蛋白(由NF2编码)功能丧失所影响的信号通路进行系统研究,已为NF1和NF2患者带来了治疗进展。在SWN综合征中,遗传情况更为复杂,已知的2个致病基因(SMARCB1和LZTR1)在多达50%的家族性SWN患者中发挥作用。对这些综合征分子基础的理解正在迅速发展,为患者提供了更多治疗选择。此外,常见的散发性癌症在NF1(即胶质母细胞瘤、乳腺癌、黑色素瘤)、NF2(即脑膜瘤、间皮瘤)和SMARCB1(即非典型畸胎样/横纹肌样肿瘤)中存在体细胞改变,因此,综合征性肿瘤治疗方面的进展可能会使有或没有种系突变的患者都受益。在这篇综述中,我们讨论了NF1、NF2和SWN的临床和遗传特征、这些综合征中出现的肿瘤的治疗进展,以及这些罕见肿瘤综合征与具有相同突变的常见肿瘤之间的相互作用。
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