通过使用达拉非尼联合曲美替尼靶向BRAF V600E突变成功治疗患有软脑膜转移的高级别胶质瘤的儿科患者:两个说明性病例
Successful treatment of pediatric patients with high-grade gliomas featuring leptomeningeal metastases by targeting BRAF V600E mutations with dabrafenib plus trametinib: two illustrative cases.
作者信息
Kawaguchi Yuki, Watanabe Yuko, Miyakita Yasuji, Ohno Makoto, Ogawa Chitose, Takahashi Masamichi, Yanagisawa Shunsuke, Mukai Takayuki, Igaki Hiroshi, Sugino Hirokazu, Yoshida Akihiko, Narita Yoshitaka
机构信息
Department of Neurosurgery and Neuro-Oncology, National Cancer Center, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045 Japan.
Department of Pediatric Oncology, National Cancer Center, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045 Japan.
出版信息
Int Cancer Conf J. 2024 Apr 10;13(3):256-262. doi: 10.1007/s13691-024-00674-6. eCollection 2024 Jul.
A combination of BRAF and MEK inhibitors is reported to be effective for gliomas with the BRAF V600E mutation; however, its efficacy in gliomas with leptomeningeal metastases (LMM) is still unknown. In this report, we describe two pediatric patients with high-grade glioma featuring the BRAF V600E mutation who were treated with dabrafenib and trametinib for LMM. Both 2 cases underwent craniotomy for primary intracranial lesions and were diagnosed as a high-grade glioma with BRAF V600E mutation; one case was consistent with anaplastic pleomorphic xanthoastorocytoma, the other was epithelioid glioblastoma. They received standard treatment for the lesions but subsequently were found to have new lesions including multiple spinal dissemination. We started administering dabrafenib and trametinib. Within a few days of starting treatment, the symptoms improved dramatically and MRI performed one month after the prescription of the two drugs demonstrated remission of both brain and spinal lesions. This report shows that dabrafenib and trametinib are effective not only for recurrent lesions but also for LMM in pediatric patients.
据报道,BRAF和MEK抑制剂联合使用对具有BRAF V600E突变的胶质瘤有效;然而,其对伴有软脑膜转移(LMM)的胶质瘤的疗效仍不清楚。在本报告中,我们描述了两名患有BRAF V600E突变的高级别胶质瘤的儿科患者,他们接受了达拉非尼和曲美替尼治疗LMM。两例均因原发性颅内病变接受了开颅手术,并被诊断为具有BRAF V600E突变的高级别胶质瘤;一例符合间变性多形性黄色星形细胞瘤,另一例为上皮样胶质母细胞瘤。他们接受了针对病变的标准治疗,但随后发现有新的病变,包括多处脊髓播散。我们开始给予达拉非尼和曲美替尼。开始治疗后的几天内,症状显著改善,在两种药物处方后一个月进行的MRI显示脑和脊髓病变均缓解。本报告表明,达拉非尼和曲美替尼不仅对复发性病变有效,而且对儿科患者的LMM也有效。