nach oben

14.02.2025 | Review

Targeted treatment for craniopharyngioma

verfasst von: Natalie E. Stec, Fred G. Barker II, Priscilla K. Brastianos

Erschienen in: Journal of Neuro-Oncology

Einloggen, um Zugang zu erhalten

Abstract

Introduction

Craniopharyngioma is a rare solid-cystic tumor of the hypothalamopituitary region. Two distinct craniopharyngioma types (formerly subtypes), adamantinomatous and papillary, have been described. These tumors often manifest with neuroendocrine dysfunction, vision problems, hydrocephalus, and cognitive changes. Despite efforts to spare vital brain structures, conventional treatments such as surgery and radiation can exacerbate preceding deficits and contribute to permanent neurologic impairment. Recent studies have identified BRAF-V600E mutations in nearly all papillary craniopharyngiomas (PCP), and CTNNB1/Wnt pathway alterations in adamantinomatous craniopharyngiomas (ACP). These discoveries have advanced our understanding of craniopharyngioma pathogenesis and have opened opportunities for targeted biological treatments.

Purpose

The primary objective of this article is to review the current landscape of targeted treatments in papillary and adamantinomatous craniopharyngioma.

Results

Treatment of PCP with BRAF/MEK inhibition has demonstrated durable tumor response in the adjuvant and neoadjuvant settings in multiple case studies and one phase II clinical trial. Although treatment advances are more limited for ACP, CTNNB1/Wnt pathway inhibitors showed promising results in pre-clinical studies and are under continued investigation.

Conclusion

The efficacy of BRAF/MEK inhibition in PCP supports the use of targeted therapy in patients with newly diagnosed PCP. The optimal targeted treatment combinations and their timing, duration, long-term effects, and sequencing with traditional therapeutic modalities have not been established and warrant further study. Targeted therapies represent a significant advancement in the field of oncology, and craniopharyngiomas are viable candidates for these approaches pending further research.

Louis DN et al (2021) The 2021 WHO classification of tumors of the Central Nervous System: a summary. Neuro Oncol 23:1231–1251. https://doi.org/10.1093/neuonc/noab106CrossRefPubMedPubMedCentral

Duff J et al (2000) Long-term outcomes for surgically resected craniopharyngiomas. Neurosurgery 46:291–302 discussion 302– 295. https://doi.org/10.1097/00006123-200002000-00007CrossRefPubMed

Alboqami MN et al (2024) A comprehensive review of the clinical presentation, radiological findings, management, and future perspective. Heliyon 10:e32112. https://doi.org/10.1016/j.heliyon.2024.e32112. CraniopharyngiomaCrossRefPubMedPubMedCentral

Pascual JM, Prieto R, Barrios L (2019) Harvey Cushing’s craniopharyngioma treatment: part 1. Identification and clinicopathological characterization of this challenging pituitary tumor. J Neurosurg 131:949–963. https://doi.org/10.3171/2018.5.Jns18153CrossRefPubMed

Giese H, Haenig B, Haenig A, Unterberg A, Zweckberger K (2020) Neurological and neuropsychological outcome after resection of craniopharyngiomas. J Neurosurg 132:1425–1434. https://doi.org/10.3171/2018.10.Jns181557CrossRefPubMed

Zacharia BE et al (2012) Incidence, treatment and survival of patients with craniopharyngioma in the surveillance, epidemiology and end results program. Neuro Oncol 14:1070–1078. https://doi.org/10.1093/neuonc/nos142CrossRefPubMedPubMedCentral

Momin AA et al (2021) Descriptive epidemiology of craniopharyngiomas in the United States. Pituitary 24:517–522. https://doi.org/10.1007/s11102-021-01127-6CrossRefPubMed

Buslei R et al (2005) Common mutations of beta-catenin in adamantinomatous craniopharyngiomas but not in other tumours originating from the sellar region. Acta Neuropathol 109:589–597. https://doi.org/10.1007/s00401-005-1004-xCrossRefPubMed

Hölsken A et al (2009) Target gene activation of the wnt signaling pathway in nuclear beta-catenin accumulating cells of adamantinomatous craniopharyngiomas. Brain Pathol 19:357–364. https://doi.org/10.1111/j.1750-3639.2008.00180.xCrossRefPubMed

10.

Sekine S et al (2002) Craniopharyngiomas of adamantinomatous type harbor beta-catenin gene mutations. Am J Pathol 161:1997–2001. https://doi.org/10.1016/s0002-9440(10)64477-xCrossRefPubMedPubMedCentral

11.

Brastianos PK et al (2014) Exome sequencing identifies BRAF mutations in papillary craniopharyngiomas. Nat Genet 46:161–165. https://doi.org/10.1038/ng.2868CrossRefPubMedPubMedCentral

12.

Goschzik T et al (2017) Genomic alterations of Adamantinomatous and Papillary Craniopharyngioma. J Neuropathol Exp Neurol 76:126–134. https://doi.org/10.1093/jnen/nlw116CrossRefPubMed

13.

Hölsken A et al (2016) Adamantinomatous and papillary craniopharyngiomas are characterized by distinct epigenomic as well as mutational and transcriptomic profiles. Acta Neuropathol Commun 4:20. https://doi.org/10.1186/s40478-016-0287-6CrossRefPubMedPubMedCentral

14.

Godil SS et al (2022) Long-term tumor control after endoscopic endonasal resection of craniopharyngiomas: comparison of gross-total resection versus subtotal resection with radiation therapy. J Neurosurg 136:1347–1355. https://doi.org/10.3171/2021.5.Jns202011CrossRefPubMed

15.

Bobeff EJ et al (2023) Predictors of extent of resection and recurrence following endoscopic endonasal resection of craniopharyngioma. J Neurosurg 139:1235–1246. https://doi.org/10.3171/2023.3.Jns222607CrossRefPubMed

16.

Elliott RE et al (2010) Efficacy and safety of radical resection of primary and recurrent craniopharyngiomas in 86 children. J Neurosurg Pediatr 5:30–48. https://doi.org/10.3171/2009.7.Peds09215CrossRefPubMed

17.

Schoenfeld A et al (2012) The superiority of conservative resection and adjuvant radiation for craniopharyngiomas. J Neurooncol 108:133–139. https://doi.org/10.1007/s11060-012-0806-7CrossRefPubMed

18.

Akinduro OO et al (2019) Endocrine and visual outcomes following gross total resection and Subtotal Resection of Adult Craniopharyngioma: systematic review and Meta-analysis. World Neurosurg 127:e656–e668. https://doi.org/10.1016/j.wneu.2019.03.239CrossRefPubMed

19.

Scarzello G et al (2006) Acute and late morbidity after limited resection and focal radiation therapy in craniopharyngiomas. J Pediatr Endocrinol Metab 19(Suppl 1):399–405PubMed

20.

Yang I et al (2010) Craniopharyngioma: a comparison of tumor control with various treatment strategies. Neurosurg Focus 28:E5. https://doi.org/10.3171/2010.1.Focus09307CrossRefPubMed

21.

Dandurand C, Sepehry AA, Asadi Lari MH, Akagami R, Gooderham P (2018) Adult craniopharyngioma: Case Series, systematic review, and Meta-Analysis. Neurosurgery 83:631–641. https://doi.org/10.1093/neuros/nyx570CrossRefPubMed

22.

Poiset SJ et al (2024) Long-term outcomes of surgery and Radiation Treatment for adult patients with Craniopharyngioma. World Neurosurg 187:e852–e859. https://doi.org/10.1016/j.wneu.2024.04.177CrossRefPubMed

23.

Wang G, Zhang X, Feng M, Guo F (2018) Comparing survival outcomes of gross total resection and subtotal resection with radiotherapy for craniopharyngioma: a meta-analysis. J Surg Res 226:131–139. https://doi.org/10.1016/j.jss.2018.01.029CrossRefPubMed

24.

Patel VS et al (2017) Outcomes after endoscopic endonasal resection of Craniopharyngiomas in the Pediatric Population. World Neurosurg 108:6–14. https://doi.org/10.1016/j.wneu.2017.08.058CrossRefPubMed

25.

Bereket A (2020) Postoperative and long-term endocrinologic complications of Craniopharyngioma. Horm Res Paediatr 93:497–509. https://doi.org/10.1159/000515347CrossRefPubMed

26.

Caklili M et al (2024) Surgical outcomes and follow-up results of 53 pediatric craniopharyngioma cases: a single-center study. J Neurosurg Pediatr 33:223–235. https://doi.org/10.3171/2023.10.Peds23293CrossRefPubMed

27.

Sadhasivam S, Menon G, Abraham M, Arora RK, Nair SN (2023) The influence of tumor topography on the surgical outcome of craniopharyngiomas. J Neurosurg 139:1247–1257. https://doi.org/10.3171/2023.3.Jns222302CrossRefPubMed

28.

Elowe-Gruau E et al (2013) Childhood craniopharyngioma: hypothalamus-sparing surgery decreases the risk of obesity. J Clin Endocrinol Metab 98:2376–2382. https://doi.org/10.1210/jc.2012-3928CrossRefPubMed

29.

Yano S, Hide T, Shinojima N (2017) Surgical outcomes of Endoscopic Endonasal Skull Base surgery of Craniopharyngiomas Evaluated according to the degree of hypothalamic extension. World Neurosurg 100:288–296. https://doi.org/10.1016/j.wneu.2017.01.005CrossRefPubMed

30.

Koutourousiou M et al (2013) Endoscopic endonasal surgery for craniopharyngiomas: surgical outcome in 64 patients. J Neurosurg 119:1194–1207. https://doi.org/10.3171/2013.6.Jns122259CrossRefPubMed

31.

Masson-Cote L et al (2013) Long-term outcomes for adult craniopharyngioma following radiation therapy. Acta Oncol 52:153–158. https://doi.org/10.3109/0284186x.2012.685525CrossRefPubMed

32.

Lo AC et al (2014) Long-term outcomes and complications in patients with craniopharyngioma: the British Columbia Cancer Agency experience. Int J Radiat Oncol Biol Phys 88:1011–1018. https://doi.org/10.1016/j.ijrobp.2014.01.019CrossRefPubMed

33.

Jimenez RB et al (2021) Proton Radiation Therapy for Pediatric Craniopharyngioma. Int J Radiat Oncol Biol Phys 110:1480–1487. https://doi.org/10.1016/j.ijrobp.2021.02.045CrossRefPubMed

34.

Lo AC et al (2016) A cross-sectional cohort study of Cerebrovascular Disease and Late effects after Radiation Therapy for Craniopharyngioma. Pediatr Blood Cancer 63:786–793. https://doi.org/10.1002/pbc.25889CrossRefPubMed

35.

Olsson DS, Andersson E, Bryngelsson I-L, Nilsson AG, Johannsson G (2015) Excess mortality and morbidity in patients with Craniopharyngioma, especially in patients with Childhood Onset: a Population-based study in Sweden. J Clin Endocrinol Metabolism 100:467–474. https://doi.org/10.1210/jc.2014-3525CrossRef

36.

Rutenberg MS et al (2022) Disease Control after Radiotherapy for Adult Craniopharyngioma: clinical outcomes from a large single-Institution Series. J Neurooncol 157:425–433. https://doi.org/10.1007/s11060-022-03983-zCrossRefPubMed

37.

Merchant TE et al (2023) Pediatric Craniopharyngioma: the Effect of Visual deficits and hormone deficiencies on long-term cognitive outcomes after Conformal Photon Radiation Therapy. Int J Radiat Oncol Biol Phys 115:581–591. https://doi.org/10.1016/j.ijrobp.2022.09.061CrossRefPubMed

38.

Liu AK et al (2009) Vascular abnormalities in pediatric craniopharyngioma patients treated with radiation therapy. Pediatr Blood Cancer 52:227–230. https://doi.org/10.1002/pbc.21787CrossRefPubMed

39.

Edmonston DY et al (2022) Limited surgery and conformal photon radiation therapy for pediatric craniopharyngioma: long-term results from the RT1 protocol. Neuro Oncol 24:2200–2209. https://doi.org/10.1093/neuonc/noac124CrossRefPubMedPubMedCentral

40.

Castle-Kirszbaum M, Shi MDY, Goldschlager T (2022) Quality of life in Craniopharyngioma: a systematic review. World Neurosurg 164:424–435e422. https://doi.org/10.1016/j.wneu.2022.05.038CrossRefPubMed

41.

Cavalheiro S et al (2010) Craniopharyngiomas: intratumoral chemotherapy with interferon-alpha: a multicenter preliminary study with 60 cases. Neurosurg Focus 28:E12. https://doi.org/10.3171/2010.1.Focus09310CrossRefPubMed

42.

Kickingereder P et al (2012) Intracavitary brachytherapy using stereotactically applied phosphorus-32 colloid for treatment of cystic craniopharyngiomas in 53 patients. J Neurooncol 109:365–374. https://doi.org/10.1007/s11060-012-0902-8CrossRefPubMed

43.

Liu W et al (2012) Intracystic bleomycin for cystic craniopharyngiomas in children (abridged republication of cochrane systematic review). Neurosurgery 71:909–915. https://doi.org/10.1227/NEU.0b013e31826d5c31CrossRefPubMed

44.

Hader WJ, Steinbok P, Hukin J, Fryer C (2000) Intratumoral therapy with bleomycin for cystic craniopharyngiomas in children. Pediatr Neurosurg 33:211–218. https://doi.org/10.1159/000055955CrossRefPubMed

45.

Karasarides M et al (2004) B-RAF is a therapeutic target in melanoma. Oncogene 23:6292–6298. https://doi.org/10.1038/sj.onc.1207785CrossRefPubMed

46.

Degirmenci U, Wang M, Hu J, Targeting Aberrant (2020) RAS/RAF/MEK/ERK Signaling for Cancer Therapy. Cells 9. https://doi.org/10.3390/cells9010198

47.

Riely GJ et al (2023) Phase II, open-label study of Encorafenib Plus Binimetinib in patients with BRAF(V600)-Mutant metastatic non-small-cell Lung Cancer. J Clin Oncol 41:3700–3711. https://doi.org/10.1200/jco.23.00774CrossRefPubMed

48.

Long GV et al (2014) Combined BRAF and MEK inhibition versus BRAF inhibition alone in melanoma. N Engl J Med 371:1877–1888. https://doi.org/10.1056/NEJMoa1406037CrossRefPubMed

49.

Kopetz, S.et al. Encorafenib, Binimetinib, and Cetuximab in < i > BRAF V600E–Mutated Colorectal Cancer. New England Journal of Medicine381, 1632–1643 (2019). https://doi.org/doi:10.1056/NEJMoa1908075

50.

Kreitman RJ et al (2023) Dabrafenib plus Trametinib in patients with relapsed/refractory BRAF V600E mutation-positive hairy cell leukemia. Blood 141:996–1006. https://doi.org/10.1182/blood.2021013658CrossRefPubMed

51.

Barbato MI et al (2024) FDA approval Summary: Dabrafenib in Combination with Trametinib for BRAFV600E mutation-positive low-Grade Glioma. Clin Cancer Res 30:263–268. https://doi.org/10.1158/1078-0432.Ccr-23-1503CrossRefPubMedPubMedCentral

52.

Poulikakos PI et al (2011) RAF inhibitor resistance is mediated by dimerization of aberrantly spliced BRAF(V600E). Nature 480:387–390. https://doi.org/10.1038/nature10662CrossRefPubMedPubMedCentral

53.

Tian Y, Guo WA (2020) Review of the molecular pathways involved in resistance to BRAF inhibitors in patients with Advanced-Stage Melanoma. Med Sci Monit 26:e920957. https://doi.org/10.12659/msm.920957CrossRefPubMedPubMedCentral

54.

Long GV et al (2015) Dabrafenib and trametinib versus dabrafenib and placebo for Val600 BRAF-mutant melanoma: a multicentre, double-blind, phase 3 randomised controlled trial. Lancet 386:444–451. https://doi.org/10.1016/S0140-6736(15)60898-4CrossRefPubMed

55.

Hanrahan AJ, Chen Z, Rosen N, Solit DB (2024) BRAF - a tumour-agnostic drug target with lineage-specific dependencies. Nat Rev Clin Oncol 21:224–247. https://doi.org/10.1038/s41571-023-00852-0CrossRefPubMed

56.

Heinzerling L et al (2019) Tolerability of BRAF/MEK inhibitor combinations: adverse event evaluation and management. ESMO Open 4:e000491. https://doi.org/10.1136/esmoopen-2019-000491CrossRefPubMedPubMedCentral

57.

Mackin AG et al (2019) Inflammatory side effects of BRAF and MEK inhibitors. Melanoma Res 29:522–526. https://doi.org/10.1097/cmr.0000000000000599CrossRefPubMed

58.

Flaherty KT et al (2012) Improved survival with MEK inhibition in BRAF-mutated melanoma. N Engl J Med 367:107–114. https://doi.org/10.1056/NEJMoa1203421CrossRefPubMed

59.

Garutti M et al (2022) BRAF and MEK inhibitors and their toxicities: a Meta-analysis. Cancers (Basel) 15. https://doi.org/10.3390/cancers15010141

60.

Boussemart L et al (2013) Prospective study of cutaneous side-effects associated with the BRAF inhibitor vemurafenib: a study of 42 patients. Ann Oncol 24:1691–1697. https://doi.org/10.1093/annonc/mdt015CrossRefPubMed

61.

Holderfield M, Nagel TE, Stuart DD (2014) Mechanism and consequences of RAF kinase activation by small-molecule inhibitors. Br J Cancer 111:640–645. https://doi.org/10.1038/bjc.2014.139CrossRefPubMedPubMedCentral

62.

Sanlorenzo M et al (2014) Comparative profile of cutaneous adverse events: BRAF/MEK inhibitor combination therapy versus BRAF monotherapy in melanoma. J Am Acad Dermatol 71:1102–1109e1101. https://doi.org/10.1016/j.jaad.2014.09.002CrossRefPubMedPubMedCentral

63.

Banks M, Crowell K, Proctor A, Jensen BC (2017) Cardiovascular effects of the MEK inhibitor, Trametinib: a Case Report, Literature Review, and consideration of mechanism. Cardiovasc Toxicol 17:487–493. https://doi.org/10.1007/s12012-017-9425-zCrossRefPubMedPubMedCentral

64.

Zhu H et al (2017) Increased apoptosis in the Paraventricular Nucleus mediated by AT1R/Ras/ERK1/2 signaling results in sympathetic hyperactivity and renovascular hypertension in rats after kidney Injury. Front Physiol 8:41. https://doi.org/10.3389/fphys.2017.00041CrossRefPubMedPubMedCentral

65.

Bronte G et al (2015) Conquests and perspectives of cardio-oncology in the field of tumor angiogenesis-targeting tyrosine kinase inhibitor-based therapy. Expert Opin Drug Saf 14:253–267. https://doi.org/10.1517/14740338.2015.986092CrossRefPubMed

66.

Totzeck M et al (2012) Nitrite regulates hypoxic vasodilation via myoglobin-dependent nitric oxide generation. Circulation 126:325–334. https://doi.org/10.1161/circulationaha.111.087155CrossRefPubMedPubMedCentral

67.

Guha A et al (2021) Cardiovascular adverse events associated with BRAF versus BRAF/MEK inhibitor: cross-sectional and longitudinal analysis using two large national registries. Cancer Med 10:3862–3872. https://doi.org/10.1002/cam4.3938CrossRefPubMedPubMedCentral

68.

Mincu RI et al (2019) Cardiovascular adverse events Associated with BRAF and MEK inhibitors: a systematic review and Meta-analysis. JAMA Netw Open 2:e198890. https://doi.org/10.1001/jamanetworkopen.2019.8890CrossRefPubMedPubMedCentral

69.

Mettler C et al (2021) Ocular Safety Profile of BRAF and MEK inhibitors: data from the World Health Organization Pharmacovigilance Database. Ophthalmology 128:1748–1755. https://doi.org/10.1016/j.ophtha.2021.05.008CrossRefPubMed

70.

Méndez-Martínez S et al (2019) OCULAR ADVERSE EVENTS ASSOCIATED WITH MEK INHIBITORS. Retina 39:1435–1450. https://doi.org/10.1097/iae.0000000000002451CrossRefPubMed

71.

Urner-Bloch U et al (2016) MEK inhibitor-associated retinopathy (MEKAR) in metastatic melanoma: long-term ophthalmic effects. Eur J Cancer 65:130–138. https://doi.org/10.1016/j.ejca.2016.06.018CrossRefPubMed

72.

Niro A et al (2015) Ocular toxicity in metastatic melanoma patients treated with mitogen-activated protein kinase kinase inhibitors: a Case Series. Am J Ophthalmol 160:959–967e951. https://doi.org/10.1016/j.ajo.2015.07.035CrossRefPubMed

73.

Brastianos PK et al (2023) BRAF-MEK inhibition in newly diagnosed Papillary Craniopharyngiomas. N Engl J Med 389:118–126. https://doi.org/10.1056/NEJMoa2213329CrossRefPubMedPubMedCentral

74.

Giraud V et al (2015) Relapsing pneumonitis due to two distinct inhibitors of the MAPK/ERK pathway: report of a case. BMC Cancer 15:732. https://doi.org/10.1186/s12885-015-1754-3CrossRefPubMedPubMedCentral

75.

Robert C et al (2019) Five-year outcomes from a phase 3 METRIC study in patients with BRAF V600 E/K-mutant advanced or metastatic melanoma. Eur J Cancer 109:61–69. https://doi.org/10.1016/j.ejca.2018.12.015CrossRefPubMed

76.

Meirson T, Asher N, Bomze D, Markel G (2020) Safety of BRAF + MEK inhibitor combinations: severe adverse event evaluation. Cancers (Basel) 12. https://doi.org/10.3390/cancers12061650

77.

Perico L et al (2017) BRAF Signaling Pathway Inhibition, Podocyte Injury, and nephrotic syndrome. Am J Kidney Dis 70:145–150. https://doi.org/10.1053/j.ajkd.2016.12.013CrossRefPubMed

78.

Maanaoui M et al (2017) Glomerulonephritis and granulomatous vasculitis in kidney as a complication of the use of BRAF and MEK inhibitors in the treatment of metastatic melanoma: a case report. Med (Baltim) 96:e7196. https://doi.org/10.1097/md.0000000000007196CrossRef

79.

Sanagawa A et al (2021) BRAF/MEK inhibitor-associated nephrotoxicity in a real-world setting and human kidney cells. Anticancer Drugs 32:1076–1083. https://doi.org/10.1097/cad.0000000000001106CrossRefPubMed

80.

Brastianos PK et al (2016) Dramatic response of BRAF V600E Mutant Papillary Craniopharyngioma to targeted therapy. J Natl Cancer Inst 108. https://doi.org/10.1093/jnci/djv310

81.

Aylwin SJ, Bodi I, Beaney R (2016) Pronounced response of papillary craniopharyngioma to treatment with vemurafenib, a BRAF inhibitor. Pituitary 19:544–546. https://doi.org/10.1007/s11102-015-0663-4CrossRefPubMed

82.

Rostami E et al (2017) Recurrent papillary craniopharyngioma with BRAFV600E mutation treated with neoadjuvant-targeted therapy. Acta Neurochir (Wien) 159:2217–2221. https://doi.org/10.1007/s00701-017-3311-0CrossRefPubMed

83.

Roque A, Odia Y (2017) BRAF-V600E mutant papillary craniopharyngioma dramatically responds to combination BRAF and MEK inhibitors. CNS Oncol 6:95–99. https://doi.org/10.2217/cns-2016-0034CrossRefPubMedPubMedCentral

84.

Himes BT et al (2019) Recurrent papillary craniopharyngioma with BRAF V600E mutation treated with dabrafenib: case report. J Neurosurg 130:1299–1303. https://doi.org/10.3171/2017.11.Jns172373CrossRefPubMed

85.

Bernstein A et al (2020) Dual BRAF/MEK therapy in BRAF V600E-mutated primary brain tumors: a case series showing dramatic clinical and radiographic responses and a reduction in cutaneous toxicity. J Neurosurg 133:1704–1709. https://doi.org/10.3171/2019.8.Jns19643CrossRefPubMed

86.

Rao M, Bhattacharjee M, Shepard S, Hsu S (2019) Newly diagnosed papillary craniopharyngioma with BRAF V600E mutation treated with single-agent selective BRAF inhibitor dabrafenib: a case report. Oncotarget 10:6038–6042. https://doi.org/10.18632/oncotarget.27203CrossRefPubMedPubMedCentral

87.

Khaddour K, Chicoine MR, Huang J, Dahiya S, Ansstas G (2020) Successful use of BRAF/MEK inhibitors as a Neoadjuvant Approach in the definitive treatment of Papillary Craniopharyngioma. J Natl Compr Canc Netw 18:1590–1595. https://doi.org/10.6004/jnccn.2020.7624CrossRefPubMed

88.

Gopal M, Thakur G, Puduvalli V (2020) Initial presentation of Papillary Craniopharyngioma with BRAF Mutation Treated with adjuvant chemotherapy (867). Neurology 94:867. https://doi.org/10.1212/WNL.94.15_supplement.867CrossRef

89.

Di Stefano AL et al (2020) Medical debulking with BRAF/MEK inhibitors in aggressive BRAF-mutant craniopharyngioma. Neurooncol Adv 2:vdaa141. https://doi.org/10.1093/noajnl/vdaa141CrossRefPubMedPubMedCentral

90.

Chik CL, van Landeghem FKH, Easaw JC, Mehta V (2021) Aggressive childhood-onset Papillary Craniopharyngioma Managed with Vemurafenib, a BRAF inhibitor. J Endocr Soc 5:bvab043. https://doi.org/10.1210/jendso/bvab043CrossRefPubMedPubMedCentral

91.

Calvanese F et al (2022) Neoadjuvant B-RAF and MEK inhibitor targeted therapy for adult Papillary craniopharyngiomas: a New Treatment paradigm. Front Endocrinol (Lausanne) 13:882381. https://doi.org/10.3389/fendo.2022.882381CrossRefPubMed

92.

Nussbaum PE et al (2022) Case report and literature review of BRAF-V600 inhibitors for treatment of papillary craniopharyngiomas: a potential treatment paradigm shift. J Clin Pharm Ther 47:826–831. https://doi.org/10.1111/jcpt.13600CrossRefPubMed

93.

Wu ZP et al (2023) Case Report: successful use of BRAF/MEK inhibitors in aggressive BRAF-mutant Craniopharyngioma. World Neurosurg 180:e117–e126. https://doi.org/10.1016/j.wneu.2023.08.137CrossRefPubMed

94.

Yu N et al (2024) Promising response to vemurafenib and cobimetinib treatment for BRAF V600E mutated craniopharyngioma: a case report and literature review. CNS Oncol 13:Cns106. https://doi.org/10.2217/cns-2023-0018CrossRefPubMedPubMedCentral

95.

Butt SU et al (2021) BRAF/MEK inhibitors for BRAF V600E-mutant cancers in non-approved setting: a case series. Cancer Chemother Pharmacol 87:437–441. https://doi.org/10.1007/s00280-021-04234-0CrossRefPubMed

96.

Shah SN, Kaki PC, Shah SS, Shah SA (2023) Concurrent Radiation and targeted therapy for Papillary Craniopharyngioma: a Case Report. Cureus 15:e40190. https://doi.org/10.7759/cureus.40190CrossRefPubMedPubMedCentral

97.

De Alcubierre D et al (2024) BRAF and MEK inhibitor targeted therapy in papillary craniopharyngiomas: a cohort study. Eur J Endocrinol 191:251–261. https://doi.org/10.1093/ejendo/lvae091CrossRefPubMed

98.

Juratli TA et al (2019) Targeted treatment of papillary craniopharyngiomas harboring BRAF V600E mutations. Cancer 125:2910–2914. https://doi.org/10.1002/cncr.32197CrossRefPubMed

99.

Lin AL, Tabar V, Young RJ, Geer EB (2023) Dabrafenib as a diagnostic and therapeutic strategy for the non-surgical management of papillary craniopharyngioma. Pituitary 26:482–487. https://doi.org/10.1007/s11102-023-01339-yCrossRefPubMedPubMedCentral

100.

Cossu G et al (2024) Update on neoadjuvant and adjuvant BRAF inhibitors in Papillary Craniopharyngioma: a systematic review. Cancers (Basel) 16. https://doi.org/10.3390/cancers16203479

101.

Planchard D et al (2016) Dabrafenib plus Trametinib in patients with previously treated BRAF(V600E)-mutant metastatic non-small cell lung cancer: an open-label, multicentre phase 2 trial. Lancet Oncol 17:984–993. https://doi.org/10.1016/s1470-2045(16)30146-2CrossRefPubMedPubMedCentral

102.

Planchard D et al (2017) Dabrafenib plus Trametinib in patients with previously untreated BRAF(V600E)-mutant metastatic non-small-cell lung cancer: an open-label, phase 2 trial. Lancet Oncol 18:1307–1316. https://doi.org/10.1016/s1470-2045(17)30679-4CrossRefPubMed

103.

Yue Q et al (2018) Prediction of BRAF mutation status of craniopharyngioma using magnetic resonance imaging features. J Neurosurg 129:27–34. https://doi.org/10.3171/2017.4.Jns163113CrossRefPubMed

104.

Pascual JM, Prieto R, Carrasco R, Barrios L (2022) Duct-like diverticulum at the base of third ventricle tumors: a morphological signature diagnostic of papillary craniopharyngioma. Neurosurg Rev 45:3361–3379. https://doi.org/10.1007/s10143-022-01848-7CrossRefPubMed

105.

Fujio S et al (2019) A clinical rule for preoperative prediction of BRAF Mutation Status in Craniopharyngiomas. Neurosurgery 85:204–210. https://doi.org/10.1093/neuros/nyy569CrossRefPubMed

106.

Huang ZS et al (2021) Machine learning-based Multiparametric magnetic resonance imaging Radiomic Model for discrimination of pathological subtypes of Craniopharyngioma. J Magn Reson Imaging 54:1541–1550. https://doi.org/10.1002/jmri.27761CrossRefPubMed

107.

Jimeno A et al (2017) A first-in-human phase I study of the Anticancer Stem Cell Agent Ipafricept (OMP-54F28), a Decoy receptor for wnt ligands, in patients with Advanced Solid tumors. Clin Cancer Res 23:7490–7497. https://doi.org/10.1158/1078-0432.Ccr-17-2157CrossRefPubMed

108.

Dotan E et al (2020) Phase ib study of wnt inhibitor ipafricept with Gemcitabine and nab-paclitaxel in patients with previously untreated stage IV pancreatic Cancer. Clin Cancer Res 26:5348–5357. https://doi.org/10.1158/1078-0432.Ccr-20-0489CrossRefPubMedPubMedCentral

109.

Moore KN et al (2019) A phase 1b dose escalation study of ipafricept (OMP54F28) in combination with paclitaxel and carboplatin in patients with recurrent platinum-sensitive ovarian cancer. Gynecol Oncol 154:294–301. https://doi.org/10.1016/j.ygyno.2019.04.001CrossRefPubMedPubMedCentral

110.

Fischer MM et al (2017) WNT antagonists exhibit unique combinatorial antitumor activity with taxanes by potentiating mitotic cell death. Sci Adv 3:e1700090. https://doi.org/10.1126/sciadv.1700090CrossRefPubMedPubMedCentral

111.

Smith DC et al (2013) First-in-human evaluation of the human monoclonal antibody vantictumab (OMP-18R5; anti-frizzled) targeting the WNT pathway in a phase I study for patients with advanced solid tumors. J Clin Oncol 31:2540–2540. https://doi.org/10.1200/jco.2013.31.15_suppl.2540CrossRef

112.

Diamond JR et al (2020) Phase ib clinical trial of the anti-frizzled antibody vantictumab (OMP-18R5) plus paclitaxel in patients with locally advanced or metastatic HER2-negative breast cancer. Breast Cancer Res Treat 184:53–62. https://doi.org/10.1007/s10549-020-05817-wCrossRefPubMedPubMedCentral

113.

Davis SL et al (2020) A phase 1b dose escalation study of wnt pathway inhibitor vantictumab in combination with nab-paclitaxel and gemcitabine in patients with previously untreated metastatic pancreatic cancer. Invest New Drugs 38:821–830. https://doi.org/10.1007/s10637-019-00824-1CrossRefPubMed

114.

Goyal L et al (2020) Phase I and Biomarker Study of the wnt pathway modulator DKN-01 in combination with Gemcitabine/Cisplatin in advanced biliary Tract Cancer. Clin Cancer Res 26:6158–6167. https://doi.org/10.1158/1078-0432.Ccr-20-1310CrossRefPubMed

115.

Turkes FS et al (2022) 1253P safety and efficacy of wnt inhibition with a DKK1 inhibitor, DKN-01, in combination with atezolizumab in patients with advanced oesophagogastric adenocarcinoma: phase IIa results of the WAKING trial. Ann Oncol 33:S1120–S1121. https://doi.org/10.1016/j.annonc.2022.07.1371CrossRef

116.

Bendell J et al (2016) Initial results from a phase 1a/b study of OMP-131R10, a first-in-class anti-RSPO3 antibody, in advanced solid tumors and previously treated metastatic colorectal cancer (CRC). Eur J Cancer 69:29–S30. https://doi.org/10.1016/S0959-8049(16)32668-5CrossRef

117.

Tan DSP et al (2023) A phase 1B dose escalation study of ETC-159 in combination with pembrolizumab in advanced or metastatic solid tumours. J Clin Oncol 41:2601–2601. https://doi.org/10.1200/JCO.2023.41.16_suppl.2601CrossRef

118.

Teneggi V et al (2016) 152O A phase 1, first-in-human dose escalation study of ETC-159 in advanced or metastatic solid tumours. Annals of Oncology 27, ix47 https://doi.org/10.1016/S0923-7534(21)00310-0

119.

Zhou H et al (2017) Combined inhibition of β-catenin and bcr-abl synergistically targets tyrosine kinase inhibitor-resistant blast crisis chronic myeloid leukemia blasts and progenitors in vitro and in vivo. Leukemia 31:2065–2074. https://doi.org/10.1038/leu.2017.87CrossRefPubMedPubMedCentral

120.

Wu X, Luo F, Li J, Zhong X, Liu K (2016) Tankyrase 1 inhibitior XAV939 increases chemosensitivity in colon cancer cell lines via inhibition of the wnt signaling pathway. Int J Oncol 48:1333–1340. https://doi.org/10.3892/ijo.2016.3360CrossRefPubMedPubMedCentral

121.

Roy S et al (2019) Combined treatment with cisplatin and the tankyrase inhibitor XAV-939 increases cytotoxicity, abrogates cancer-stem-like cell phenotype and increases chemosensitivity of head-and-neck squamous-cell carcinoma cells. Mutat Res Genet Toxicol Environ Mutagen 846:503084. https://doi.org/10.1016/j.mrgentox.2019.503084CrossRefPubMed

122.

Élez E et al (2022) Abstract CT514: a phase I, open-label, dose-escalation study investigating a low-density lipoprotein receptor-related protein (LRP) 5/6 inhibitor, BI 905677, in patients with advanced solid tumors. Cancer Res 82:CT514–CT514. https://doi.org/10.1158/1538-7445.Am2022-ct514CrossRef

123.

Zhang C, Zhang Z, Zhang S, Wang W, Hu P (2017) Targeting of Wnt/β-Catenin by Anthelmintic Drug Pyrvinium enhances sensitivity of Ovarian Cancer cells to Chemotherapy. Med Sci Monit 23:266–275. https://doi.org/10.12659/msm.901667CrossRefPubMedPubMedCentral

124.

Vlashi R, Zhang X, Wu M, Chen G (2023) Wnt signaling: essential roles in osteoblast differentiation, bone metabolism and therapeutic implications for bone and skeletal disorders. Genes Dis 10:1291–1317. https://doi.org/10.1016/j.gendis.2022.07.011CrossRefPubMed

125.

Zhang Y, Wang X (2020) Targeting the Wnt/β-catenin signaling pathway in cancer. J Hematol Oncol 13:165. https://doi.org/10.1186/s13045-020-00990-3CrossRefPubMedPubMedCentral

126.

Kahn M (2014) Can we safely target the WNT pathway? Nat Rev Drug Discov 13:513–532. https://doi.org/10.1038/nrd4233CrossRefPubMedPubMedCentral

127.

de Pellegars-Malhortie A, Picque Lasorsa L, Mazard T, Granier F, Prévostel C (2024) Why is Wnt/β-Catenin not yet targeted in Routine Cancer Care? Pharmaceuticals (Basel) 17. https://doi.org/10.3390/ph17070949

128.

Papadopoulos KP et al (2024) A first-in-human, phase 1/2 trial of FOG-001, a β-catenin:TCF antagonist, in patients with locally advanced or metastatic solid tumors. J Clin Oncol 42:TPS3175–TPS3175. https://doi.org/10.1200/JCO.2024.42.16_suppl.TPS3175CrossRef

129.

Apps JR et al (2018) Tumour compartment transcriptomics demonstrates the activation of inflammatory and odontogenic programmes in human adamantinomatous craniopharyngioma and identifies the MAPK/ERK pathway as a novel therapeutic target. Acta Neuropathol 135:757–777. https://doi.org/10.1007/s00401-018-1830-2CrossRefPubMedPubMedCentral

130.

Zhang H et al (2022) CD47 promotes the proliferation and migration of adamantinomatous craniopharyngioma cells by activating the MAPK/ERK pathway, and CD47 blockade facilitates microglia-mediated phagocytosis. Neuropathol Appl Neurobiol 48:e12795. https://doi.org/10.1111/nan.12795CrossRefPubMed

131.

Patel K et al (2021) Radiologic response to MEK inhibition in a patient with a WNT-activated craniopharyngioma. Pediatr Blood Cancer 68:e28753. https://doi.org/10.1002/pbc.28753CrossRefPubMed

132.

Kilburn LB et al (2024) The type II RAF inhibitor tovorafenib in relapsed/refractory pediatric low-grade glioma: the phase 2 FIREFLY-1 trial. Nat Med 30:207–217. https://doi.org/10.1038/s41591-023-02668-yCrossRefPubMed

133.

Donson AM et al (2017) Molecular analyses reveal inflammatory mediators in the Solid Component and Cyst Fluid of Human Adamantinomatous Craniopharyngioma. J Neuropathol Exp Neurol 76:779–788. https://doi.org/10.1093/jnen/nlx061CrossRefPubMedPubMedCentral

134.

Zhou J, Zhang C, Pan J, Chen L, Qi ST (2017) Interleukin–6 induces an epithelial–mesenchymal transition phenotype in human adamantinomatous craniopharyngioma cells and promotes tumor cell migration. Mol Med Rep 15:4123–4131. https://doi.org/10.3892/mmr.2017.6538CrossRefPubMedPubMedCentral

135.

Mori M, Takeshima H, Kuratsu J (2004) Expression of interleukin-6 in human craniopharyngiomas: a possible inducer of tumor-associated inflammation. Int J Mol Med 14:505–509PubMed

136.

Grob S et al (2019) Targeting IL-6 is a potential treatment for primary cystic Craniopharyngioma. Front Oncol 9:791. https://doi.org/10.3389/fonc.2019.00791CrossRefPubMedPubMedCentral

137.

Coy S et al (2024) Systematic characterization of antibody-drug conjugate targets in central nervous system tumors. Neuro Oncol 26:458–472. https://doi.org/10.1093/neuonc/noad205CrossRefPubMed

138.

Chen C et al (2019) Frequent B7-H3 overexpression in craniopharyngioma. Biochem Biophys Res Commun 514:379–385. https://doi.org/10.1016/j.bbrc.2019.04.142CrossRefPubMed

139.

Bessede A et al (2024) TROP2 is Associated with Primary Resistance to Immune Checkpoint Inhibition in patients with Advanced Non-small Cell Lung Cancer. Clin Cancer Res 30:779–785. https://doi.org/10.1158/1078-0432.Ccr-23-2566CrossRefPubMed

140.

Liao Q et al (2024) TROP2 is highly expressed in triple-negative breast cancer CTCs and is a potential marker for epithelial mesenchymal CTCs. Mol Therapy: Oncol 32:200762. https://doi.org/10.1016/j.omton.2024.200762CrossRef

141.

Ning S et al (2013) TROP2 expression and its correlation with tumor proliferation and angiogenesis in human gliomas. Neurol Sci 34:1745–1750. https://doi.org/10.1007/s10072-013-1326-8CrossRefPubMed

142.

Goldenberg DM, Stein R, Sharkey RM (2018) The emergence of trophoblast cell-surface antigen 2 (TROP-2) as a novel cancer target. Oncotarget 9:28989–29006. https://doi.org/10.18632/oncotarget.25615CrossRefPubMedPubMedCentral

143.

Xu P et al (2017) Prognostic role and clinical significance of trophoblast cell surface antigen 2 in various carcinomas. Cancer Manag Res 9:821–837. https://doi.org/10.2147/cmar.S147033CrossRefPubMedPubMedCentral

144.

Zeng P et al (2016) Impact of TROP2 expression on prognosis in solid tumors: a systematic review and Meta-analysis. Sci Rep 6:33658. https://doi.org/10.1038/srep33658CrossRefPubMedPubMedCentral

145.

Bardia A et al (2021) Sacituzumab Govitecan in Metastatic Triple-negative breast Cancer. N Engl J Med 384:1529–1541. https://doi.org/10.1056/NEJMoa2028485CrossRefPubMed

146.

Petrylak DP et al (2024) TROPHY-U-01 cohort 2: a phase II study of Sacituzumab Govitecan in Cisplatin-Ineligible patients with metastatic Urothelial Cancer Progressing after previous checkpoint inhibitor therapy. J Clin Oncol 42:3410–3420. https://doi.org/10.1200/jco.23.01720CrossRefPubMed

147.

Rugo HS et al (2023) Overall survival with sacituzumab govitecan in hormone receptor-positive and human epidermal growth factor receptor 2-negative metastatic breast cancer (TROPiCS-02): a randomised, open-label, multicentre, phase 3 trial. Lancet 402:1423–1433. https://doi.org/10.1016/s0140-6736(23)01245-xCrossRefPubMed

148.

Balinda HU et al (2024) Sacituzumab Govitecan in patients with breast cancer brain metastases and recurrent glioblastoma: a phase 0 window-of-opportunity trial. Nat Commun 15:6707. https://doi.org/10.1038/s41467-024-50558-9CrossRefPubMedPubMedCentral

149.

Altan M et al (2017) B7-H3 expression in NSCLC and its Association with B7-H4, PD-L1 and Tumor-Infiltrating Lymphocytes. Clin Cancer Res 23:5202–5209. https://doi.org/10.1158/1078-0432.Ccr-16-3107CrossRefPubMedPubMedCentral

150.

Hu X, Xu M, Hu Y, Li N, Zhou L (2021) B7-H3, negatively regulated by miR-128, promotes Colorectal Cancer Cell Proliferation and Migration. Cell Biochem Biophys 79:397–405. https://doi.org/10.1007/s12013-021-00975-0CrossRefPubMed

151.

Joshi V et al (2024) B7-H3 expression in breast Cancer and brain metastasis. Int J Mol Sci 25. https://doi.org/10.3390/ijms25073976

152.

Guo C et al (2023) B7-H3 as a therapeutic target in advanced prostate Cancer. Eur Urol 83:224–238. https://doi.org/10.1016/j.eururo.2022.09.004CrossRefPubMed

153.

Wang L et al (2013) B7-H3 is overexpressed in patients suffering osteosarcoma and associated with tumor aggressiveness and metastasis. PLoS ONE 8:e70689. https://doi.org/10.1371/journal.pone.0070689CrossRefPubMedPubMedCentral

154.

Zhang S, Zhou C, Zhang D, Huang Z, Zhang G (2019) The anti-apoptotic effect on cancer-associated fibroblasts of B7-H3 molecule enhancing the cell invasion and metastasis in renal cancer. Onco Targets Ther 12:4119–4127. https://doi.org/10.2147/ott.S201121CrossRefPubMedPubMedCentral

155.

Mahmoud AM et al (2022) Evaluation of PD-L1 and B7-H3 expression as a predictor of response to adjuvant chemotherapy in bladder cancer. BMC Urol 22:90. https://doi.org/10.1186/s12894-022-01044-1CrossRefPubMedPubMedCentral

156.

Gregorio A et al (2008) Small round blue cell tumours: diagnostic and prognostic usefulness of the expression of B7-H3 surface molecule. Histopathology 53:73–80. https://doi.org/10.1111/j.1365-2559.2008.03070.xCrossRefPubMedPubMedCentral

157.

Lynch MM et al (2024) B7-H3 is widely expressed in soft tissue sarcomas. BMC Cancer 24:1336. https://doi.org/10.1186/s12885-024-13061-4CrossRefPubMedPubMedCentral

158.

Digregorio M et al (2021) The expression of B7-H3 isoforms in newly diagnosed glioblastoma and recurrence and their functional role. Acta Neuropathol Commun 9:59. https://doi.org/10.1186/s40478-021-01167-wCrossRefPubMedPubMedCentral

159.

Zhang C et al (2018) Large-scale analysis reveals the specific clinical and immune features of B7-H3 in glioma. Oncoimmunology 7:e1461304. https://doi.org/10.1080/2162402x.2018.1461304CrossRefPubMedPubMedCentral

160.

Zhou Z et al (2013) B7-H3, a potential therapeutic target, is expressed in diffuse intrinsic pontine glioma. J Neurooncol 111:257–264. https://doi.org/10.1007/s11060-012-1021-2CrossRefPubMed

161.

Theruvath J et al (2020) Locoregionally administered B7-H3-targeted CAR T cells for treatment of atypical teratoid/rhabdoid tumors. Nat Med 26:712–719. https://doi.org/10.1038/s41591-020-0821-8CrossRefPubMedPubMedCentral

162.

Li S et al (2022) Pediatric medulloblastoma express immune checkpoint B7-H3. Clin Transl Oncol 24:1204–1208. https://doi.org/10.1007/s12094-021-02762-yCrossRefPubMedPubMedCentral

163.

Brignole C et al (2023) Antitumor activity of the investigational B7-H3 antibody-drug conjugate, vobramitamab duocarmazine, in preclinical models of neuroblastoma. J Immunother Cancer 11. https://doi.org/10.1136/jitc-2023-007174

164.

Tang M et al (2022) Evaluation of B7-H3 targeted Immunotherapy in a 3D Organoid Model of Craniopharyngioma. Biomolecules 12. https://doi.org/10.3390/biom12121744

165.

Shenderov E et al (2023) Neoadjuvant enoblituzumab in localized prostate cancer: a single-arm, phase 2 trial. Nat Med 29:888–897. https://doi.org/10.1038/s41591-023-02284-wCrossRefPubMedPubMedCentral

166.

Aggarwal C et al (2022) Dual checkpoint targeting of B7-H3 and PD-1 with enoblituzumab and pembrolizumab in advanced solid tumors: interim results from a multicenter phase I/II trial. J Immunother Cancer 10. https://doi.org/10.1136/jitc-2021-004424

167.

Shenderov E et al (2021) 620P MGC018, an anti-B7-H3 antibody-drug conjugate (ADC), in patients with advanced solid tumors: preliminary results of phase I cohort expansion. Ann Oncol 32:S657–S659CrossRef

168.

Owonikoko TK et al (2024) IDeate-Lung02: a phase 3, randomized, open-label study of ifinatamab deruxtecan (I-DXd) vs treatment of physician’s choice (TPC) in relapsed small cell lung cancer (SCLC). J Clin Oncol 42:TPS8126–TPS8126. https://doi.org/10.1200/JCO.2024.42.16_suppl.TPS8126CrossRef

169.

Patel MR et al (2022) DS-7300 (B7-H3 DXd-ADC) in patients (pts) with metastatic castration-resistant prostate cancer (mCRPC): a subgroup analysis of a phase 1/2 multicenter study. J Clin Oncol 40:87–87. https://doi.org/10.1200/JCO.2022.40.6_suppl.087CrossRef

170.

Xie L et al (2024) ARTEMIS-002: phase 2 study of HS-20093 in patients with relapsed or refractory osteosarcoma. J Clin Oncol 42:11507–11507. https://doi.org/10.1200/JCO.2024.42.16_suppl.11507CrossRef

171.

Feustel K, Martin J, Falchook GS (2024) B7-H3 inhibitors in Oncology clinical trials: a review. J Immunother Precis Oncol 7:53–66. https://doi.org/10.36401/jipo-23-18CrossRefPubMedPubMedCentral

Titel: Targeted treatment for craniopharyngioma
verfasst von: Natalie E. Stec
Fred G. Barker II
Priscilla K. Brastianos
Publikationsdatum: 14.02.2025
Verlag: Springer US
Erschienen in: Journal of Neuro-Oncology
Print ISSN: 0167-594X
Elektronische ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-025-04942-0

Kompaktes Leitlinien-Wissen Neurologie (Link öffnet in neuem Fenster)

Mit medbee Pocketcards schnell und sicher entscheiden.
Leitlinien-Wissen kostenlos und immer griffbereit auf ihrem Desktop, Handy oder Tablet.

Kostenlos registrieren

Neu im Fachgebiet Neurologie

Vom Wert der Ernährung bei neurodegenerativen Erkrankungen

25.03.2025
Parkinson-Krankheit
Podcast

Am Beispiel Parkinson zeigt sich, dass Ernährung nicht nur präventiv förderlich ist, sondern auch die Wirkung von Medikamenten und den Krankheitsverlauf beeinflusst. Prof. Dr. Andrés Ceballos-Baumann, München, fasst die aktuelle Studienlage zusammen, nennt die bestehenden Probleme und veranschaulicht seine Vorgehensweise.

Passen Psychopharmaka und Pille zusammen?

25.03.2025
FOKO 2025
Kongressbericht

Wie relevant Wechselwirkungen zwischen hormonellen Kontrazeptiva und Psychopharmaka sein können, schilderte Dr. med. Dominik Dabbert beim diesjährigen FOKO. Worauf es in der Praxis ankommt und wie gefährliche Wechselwirkungen vermieden werden können, lesen Sie hier.

ePA: Entlastung oder Mehrarbeit?

25.03.2025
FOKO 2025
Kongressbericht

Die elektronische Patientenakte (ePA) soll das Gesundheitswesen revolutionieren. Mit über 2000 Krankenhäusern und mehr als 100.000 ärztlichen Praxen ist sie eines der größten Digitalisierungsprojekte Europas. Während die Politik die ePA als „Gamechanger“ feiert, zeigt sich in der Praxis ein anderes Bild.

Einjährige Valaciclovir-Therapie schützt nicht vor Zoster-Rezidiv

24.03.2025
Herpes zoster
Nachrichten

Die Zoster Eye Disease Study (ZEDS) liefert gleich zwei ernüchternde Erkenntnisse: Eine einjährige Therapie mit niedrig dosiertem Valaciclovir kann weder einen Herpes zoster ophthalmicus (HZO) noch eine Post-Zoster-Neuralgie (PZN) verhindern.

Update Neurologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen