| Title: |
BRAF–MEK Inhibition in Newly Diagnosed Papillary Craniopharyngiomas |
| Authors: |
Brastianos, Priscilla K; Twohy, Erin; Geyer, Susan; Gerstner, Elizabeth R; Kaufmann, Timothy J; Tabrizi, Shervin; Kabat, Brian; Thierauf, Julia; Ruff, Michael W; Bota, Daniela A; Reardon, David A; Cohen, Adam L; De La Fuente, Macarena I; Lesser, Glenn J; Campian, Jian; Agarwalla, Pankaj K; Kumthekar, Priya; Mann, Bhupinder; Vora, Shivangi; Knopp, Michael; Iafrate, A John; Curry, William T; Cahill, Daniel P; Shih, Helen A; Brown, Paul D; Santagata, Sandro; Barker, Fred G; Galanis, Evanthia |
| Source: |
The New England Journal of Medicine, vol 389, iss 2 |
| Publisher Information: |
eScholarship, University of California |
| Publication Year: |
2023 |
| Collection: |
University of California: eScholarship |
| Subject Terms: |
32 Biomedical and Clinical Sciences (for-2020); 3202 Clinical Sciences (for-2020); 3211 Oncology and Carcinogenesis (for-2020); Patient Safety (rcdc); Cancer (rcdc); Neurosciences (rcdc); Clinical Trials and Supportive Activities (rcdc); Clinical Research (rcdc); 6.1 Pharmaceuticals (hrcs-rac); Humans (mesh); Craniopharyngioma (mesh); Disease Progression (mesh); Mitogen-Activated Protein Kinase Kinases (mesh); Pituitary Neoplasms (mesh); Proto-Oncogene Proteins B-raf (mesh); Vemurafenib (mesh); Antineoplastic Agents (mesh); Remission Induction (mesh); 11 Medical and Health Sciences (for); General & Internal Medicine (science-metrix); 42 Health sciences (for-2020) |
| Subject Geographic: |
118 - 126 |
| Description: |
BACKGROUND: Craniopharyngiomas, primary brain tumors of the pituitary-hypothalamic axis, can cause clinically significant sequelae. Treatment with the use of surgery, radiation, or both is often associated with substantial morbidity related to vision loss, neuroendocrine dysfunction, and memory loss. Genotyping has shown that more than 90% of papillary craniopharyngiomas carry BRAF V600E mutations, but data are lacking with regard to the safety and efficacy of BRAF-MEK inhibition in patients with papillary craniopharyngiomas who have not undergone previous radiation therapy. METHODS: Eligible patients who had papillary craniopharyngiomas that tested positive for BRAF mutations, had not undergone radiation therapy previously, and had measurable disease received the BRAF-MEK inhibitor combination vemurafenib-cobimetinib in 28-day cycles. The primary end point of this single-group, phase 2 study was objective response at 4 months as determined with the use of centrally determined volumetric data. RESULTS: Of the 16 patients in the study, 15 (94%; 95% confidence interval [CI], 70 to 100) had a durable objective partial response or better to therapy. The median reduction in the volume of the tumor was 91% (range, 68 to 99). The median follow-up was 22 months (95% CI, 19 to 30) and the median number of treatment cycles was 8. Progression-free survival was 87% (95% CI, 57 to 98) at 12 months and 58% (95% CI, 10 to 89) at 24 months. Three patients had disease progression during follow-up after therapy had been discontinued; none have died. The sole patient who did not have a response stopped treatment after 8 days owing to toxic effects. Grade 3 adverse events that were at least possibly related to treatment occurred in 12 patients, including rash in 6 patients. In 2 patients, grade 4 adverse events (hyperglycemia in 1 patient and increased creatine kinase levels in 1 patient) were reported; 3 patients discontinued treatment owing to adverse events. CONCLUSIONS: In this small, single-group study involving patients with ... |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
unknown |
| Relation: |
qt3t34r5wh; https://escholarship.org/uc/item/3t34r5wh; https://escholarship.org/content/qt3t34r5wh/qt3t34r5wh.pdf |
| DOI: |
10.1056/nejmoa2213329 |
| Availability: |
https://escholarship.org/uc/item/3t34r5wh; https://escholarship.org/content/qt3t34r5wh/qt3t34r5wh.pdf; https://doi.org/10.1056/nejmoa2213329 |
| Rights: |
public |
| Accession Number: |
edsbas.275DE437 |
| Database: |
BASE |