Trametinib for orbital plexiform neurofibromas in young children with neurofibromatosis type 1
| العنوان: | Trametinib for orbital plexiform neurofibromas in young children with neurofibromatosis type 1 |
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| المؤلفون: | Gad Dotan, Rivka Friedland, Helen Toledano, Shlomi Constantini, Rony Cohen, Iftach Yassur, Mika Shapira Rootman, Hagit Toledano-Alhadef |
| المصدر: | Child's Nervous System. 37:1909-1915 |
| بيانات النشر: | Springer Science and Business Media LLC, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Trametinib, medicine.medical_specialty, genetic structures, business.industry, MEK inhibitor, Glaucoma, General Medicine, medicine.disease, Disfigurement, Debulking, eye diseases, Surgery, 03 medical and health sciences, 0302 clinical medicine, Ptosis, 030220 oncology & carcinogenesis, Pediatrics, Perinatology and Child Health, 030221 ophthalmology & optometry, medicine, Neurology (clinical), Neurosurgery, medicine.symptom, Neurofibromatosis, business |
| الوصف: | Plexiform neurofibromas (PNF) in neurofibromatosis type 1 (NF1) are usually diagnosed in childhood and can grow rapidly during this period. In 10% of patients, PNF involve the orbital-periorbital area and may cause visual problems including glaucoma, visual loss from amblyopia (deprivational, strabismic, or refractive), optic nerve compression, or keratopathy. Ptosis, proptosis, and facial disfigurement lead to social problems and decreased self-esteem. Complete surgical removal involves significant risks and mutilation, and regrowth after debulking is not uncommon. Inhibitors of the RAS/MAPK pathway have recently been investigated for their activity in PNF. We administered the oral MEK inhibitor trametinib to five young children with NF1 and PNF of the orbital area, with visual compromise and progressive tumor growth; and followed them clinically and by volumetric MRI. Treatment was initiated at a mean age of 26.8 months (SD ± 12.8) and continued for a median 28 months (range 16–51). Doses were 0.025 mg/kg/day for children aged > 6 years and 0.032 mg/kg/day for those aged < 6 years. Volumetric MRI measurements showed a reduction of 2.9–33% at 1 year after treatment initiation, with maximal reductions of 44% and 49% in two patients, at 44 and 36 months, respectively. No change in visual function was recorded during treatment. One child reported decreased orbital pain after 2 weeks; and another, with involvement of the masseters, had increased ability to chew food. Toxicities were mostly to skin and nails, grades 1–2. Trametinib can decrease tumor size in some young children with orbital PNF and may prevent progressive disfigurement. |
| تدمد: | 1433-0350 0256-7040 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_________::1bd944f6cfd8a5dd479108fe712622e8 https://doi.org/10.1007/s00381-021-05127-6 |
| حقوق: | CLOSED |
| رقم الأكسشن: | edsair.doi...........1bd944f6cfd8a5dd479108fe712622e8 |
| قاعدة البيانات: | OpenAIRE |
Find this article in full text from Springer Verlag. | تدمد: | 14330350 02567040 |
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