Nörokütanöz Hastalıklarda Yeni ve Güncel Tedaviler

Özet

Nörokütanöz sendromlar, sinir sistemi ve cildi etkileyen, genellikle ilerleyici ve malignite riski taşıyan heterojen bozukluklardır. Geleneksel olarak cerrahi ve palyatif yöntemlere dayanan tedavi yaklaşımları, moleküler genetikteki ilerlemelerle birlikte yerini MEK ve mTOR inhibitörleri gibi hedefe yönelik ilaçlara bırakmaktadır. Nörofibromatozis tip 1, Tüberoskleroz ve Sturge-Weber sendromu gibi hastalıklarda, bu yeni tedaviler tümör hacmini azaltmada, semptomları hafifletmede ve yaşam kalitesini iyileştirmede önemli başarılar göstermektedir.

 

Neurocutaneous syndromes are heterogeneous disorders affecting the nervous system and skin, often characterized by progressive clinical features and increased malignancy risk. Treatment paradigms are shifting from traditional surgery and palliative care toward targeted molecular therapies, such as MEK and mTOR inhibitors. For conditions like Neurofibromatosis type 1, Tuberous Sclerosis, and Sturge-Weber syndrome, these advancements demonstrate significant efficacy in reducing tumor volume, managing symptoms, and improving long-term patient outcomes.

Referanslar

Little H, Kamat D, Sivaswamy L. Common Neurocutaneous Syndromes. Pediatr Ann. 2015;44(11):496-504.

Nitasha Klar, Neurocutaneous Syndromes. Handb Clin Neurol 2016;135:565-589

Plon SE, Malkin D. Childhood Cancer And Heredity. In: Pizzo PA, Poplack DG (Eds). Principles And Practice Of Pediatric Oncology. 7th Ed., Philadelphia: Wolters Kluwer; 2016:22-23. 2.

Ferner RE, Huson SM, Thomas N, Et Al. Guidelines For The Diagnosis And Management Of İndividuals With Neurofibromatosis 1. J Med Genet. 2007;44(2):81-8.

Friedman JM, Adam MP, Ardinger HH, Pagon RA, Et Al. Neurofibromatosis. Genereviews 1998 Oct 2 [Updated 2019 Jun 6].

Gutmann DH, Ferner RE, Listernick RH, Korf BR, Wolters PL, Johnson KJ. Neurofibromatosis Type 1. Nat Rev Dis Prime.2017;3:17004.

Dombi E, Solomon J, Gillespie AJ, Et Al. NF1 Plexiform Neurofibroma Growth Rate By Volumetric MRI: Relationship To Age And Body Weight. Neurology. 2007;68:643–7.

Nguyen R, Dombi E, Widemann BC, Et Al. Growth Dynamics Of Plexiform Neurofibromas: A Retrospective Cohort Study Of 201 Patients With Neurofibromatosis 1. Orphanet J Rare Dis. 2012;7:75.

Ehara, Y., Koga, M., Imafuku, S., Yamamoto, O., Yoshida, Y. Distribution Of Diffuse Plexiform Neurofibroma On The Body Surface İn Patients With Neurofibromatosis 1. J Dermatol. 2019.

Friedman JM. Epidemiology Of Neurofibromatosis Type 1. Am J Med Genet. 1999;89(1):1–6.

Azizi AA, Slavc I, Theisen BE et al. Monitoring Of Plexiform Neurofibroma İn Children And Adolescents With Neurofibromatosis Type 1 By [18 F]FDG-PET İmaging. Is İt Of Value İn Asymptomatic Patients? Pediatr Blood Cancer. 2018;65(1).

Dunning-Davies BM, Parker APJ. Annual Review Of Children With Neurofibromatosis Type 1. Arch Dis Child Educ Pract Ed. 2016;101(2):102–11

Kim DH, Murovic JA, Tiel RL, Et Al. A Series Of 397 Peripheral Neural Sheath Tumors: 30-Year Experience At Louisiana State University Health Sciences Center. J Neurosurg. 2005;102:256–66.

Jakacki RI, Dombi E, Steinberg SM, Et Al. Phase II Trial Of Pegylated İnterferon Alfa-2b İn Young Patients With Neurofibromatosis Type 1 And Unresectable Plexiform Neurofibromas. Neuro Oncol. 2017;19(2):289–97.

Robertson KA, Nalepa G, Yang FC, Et Al. Imatinib Mesylate For Plexiform Neurofibromas İn Patients With Neurofibromatosis Type 1: A Phase 2 Trial. Lancet Oncol. 2012;13:1218–24.

Dombi E, Baldwin A, Marcus LJ, Et Al. Activity Of Selumetinib İn Neurofibromatosis Type 1 Related Plexiform Neurofibromas. N Engl J Med. 2016;375(26):2550–60.

Markham A, Keam Sj. Selumetinib: First Approval. Drugs. 2020;80(9):931-7.

Konuşkan B. Nörofibromatoziste Yeni Tedaviler. Çarman KB, Editör. Nörokütanöz Hastalıklar. 1. Baskı. Ankara: Türkiye Klinikleri; 2021. P.65-70.

Mccowage GB,Mueller S, Pratilas Ca, Hargrave DR,Moertel Cl, Whitlock J. Trametinib İn Pediatric Patients With Neurofibromatosis Type 1 (Nf-1)-Associated Plexiform Neurofibroma: A Phase I/Iıa Study. J Clin Oncol. 2018;36:10504.

Toledano, H., Dotan, G., Friedland, R. Et Al. Trametinib For Orbital Plexiform Neurofibromas İn Young Children With Neurofibromatosis Type 1. Childs Nerv Syst 37, 1909–1915 (2021).

Weiss B, Plotkin S, Widemann B, Et Al. Nf106: Phase 2 Trial Of The Mek İnhibitor PD-0325901 İn Adolescents And Adults With Nf1- Related Plexiform Neurofibromas: An Nf Clinical Trials Consortium Study; Abstracts From The 18th International Symposium On Pediatric Neuro-Oncology (Ispno 2018) June 30-July 3, 2018 Hyatt Regency Hotel Denver, Colorado,Usa. Neuro-Oncology. 2018;20:İ27-İ213.

Gross AM, Dombi E, Widemann Bc. Current Status Of MEK İnhibitors İn The Treatment Of Plexiform Neurofibromas Childs Nerv Syst . 2020 Jun 30.Doi: 10.1007/S00381-020-04731-2. Online Ahead Of Print

Weiss B, Widemann Bc, Wolters P et al. Sirolimus For Progressive Neurofibromatosis Type 1-Associated Plexiform Neurofibromas: A Neurofibromatosis Clinical Trials Consortium Phase Iı Study. Neuro Oncol. 2015;17(4): 596-603.

Marjanska A, Galazka P, Wysocki M, Styczynski J. New Frontiers İn Therapy Of Peripheral Nerve Sheath Tumors İn Patients With Neurofibromatosis Type 1: Latest Evidence And Clinical Implications Anticancer Res. 2020;40(4):1817-31.

Goutagny S, Raymond E, Farese EM et al. Phase Iı Study Of Mtorc1 İnhibition By Everolimus İn Neurofibromatosis Type 2 Patients With Growing Vestibular Schwannomas. J Neurooncol. 2015;122(2):313-20.

Packer RJ, Vezina G. New Treatment Modalities İn Nf-Related Neuroglial Tumors. Childs Nerv Syst . 2020 Jun 29. Doi: 10.1007/S00381-020-04704-5. Online Ahead Of Print.

Fisher, M.J., Shih, CS., Rhodes, S.D. et al. Cabozantinib for neurofibromatosis type 1–related plexiform neurofibromas: a phase 2 trial. Nat Med 27, 165–173 (2021).

Packer, R.J., Vezina, G. New treatment modalities in NF-related neuroglial tumors. Childs Nerv Syst 36, 2377–2384 (2020).

Ebrahimi-Fakhari D, Mann LL, Poryo M, et al. Incidence of tuberoussclerosis and age at first diagnosis: new data and emerging trends from a national, prospective surveillance study. Orphanet J Rare Dis. 2018 Jul 17;13(1):117.

Crino PB. Evolving neurobiology of tuberous sclerosis complex.Acta Neuropathol. 2013 Mar;125(3):317–332.

Curatolo P, Bombardieri R, Jozwiak S. Tuberous sclerosis. Lancet.2008 Aug 23;372(9639):657–668

Peron A, Au KS, Northrup H. Genetics, genomics, and genotype-phenotype correlations of TSC: insights for clinical practice. Am J Med Genet C Semin Med Genet. 2018 Sep;178(3):281–290.

Tee AR, Fingar DC, Manning BD, et al. Tuberous sclerosis complex-1 and −2 gene products function together to inhibit mammalian target of rapamycin (mTOR)-mediated downstream signaling.Proc Natl Acad Sci U S A. 2002 Oct 15;99(21):13571–13576.

Curatolo P, Maria BL. Tuberous sclerosis. Handb Clin Neurol. 2013;111:323–331.

Curatolo P, Moavero R, de Vries PJ. Neurological and neuropsychiatric aspects of tuberous sclerosis complex. Lancet Neurol. 2015 Jul;14(7):733–745.

Moavero R, Romagnoli G, Graziola F, Curatolo P (2015) Mammalian target of rapamycin inhibitors and life-threatening conditions in tuberous sclerosis complex. Semin Pediatr Neurol 22(4):282–294

Roth J, Roach ES, Bartels U et al. Subependymal giant cell astrocytoma:diagnosis, screening, and treatment. Recommendations from the International Tuberous Sclerosis Complex Consensus Conference 2012. Pediatr Neurol 49(6):439–444

Shepherd CW, Gomez MR, Lie JT, Crowson CS (1991) Causes of death in patients with tuberous sclerosis. Mayo Clin Proc 66(8): 792–796

Frassanito P, Noya C, Tamburrini G. Current trends in the management of subependymal giant cell astrocytomas in tuberous sclerosis. Childs Nerv Syst. 2020 Oct;36(10):2527-2536. doi: 10.1007/s00381-020-04889-9. Epub 2020 Sep 25. PMID: 32978642.

Dracham CB, Shankar A, Madan R (2018) Radiation induced secondary malignancies: a review article. Radiat Oncol J 36(2):85–94

Ouyang T, Zhang N, Benjamin T, et al. (2016) Retraction note to: Subependymal giant cell astrocytoma:current concepts, management, and future directions. Childs Nerv Syst 32(4):761–761

Franz DN, Krueger DA. mTOR inhibitor therapy as a disease modifying therapy for tuberous sclerosis complex. Am J Med Genet C Semin Med Genet. 2018 Sep;178(3):365–373.

Wienecke R, Fackler I, Linsenmaier U, et al. Antitumoral activity of rapamycin in renal angiomyolipoma associated with tuberous sclerosis complex. Am J Kidney Dis. 2006 Sep;48(3):e27–9.

Franz DN, Leonard J, Tudor C, et al. Rapamycin causes regression of astrocytomas in tuberous sclerosis complex. Ann Neurol. 2006 Mar;59(3):490–498.

Krueger DA, Care MM, Holland K, et al. Everolimus for subependymal giant-cell astrocytomas in tuberous sclerosis. N Engl J Med. 2010 Nov 4;363(19):1801–1811

Franz DN, Lawson JA, Yapici Z, et al. Everolimus for treatment-refractory seizures in TSC: extension of a randomized controlled trial. Neurol Clin Pract. 2018 Oct;8(5):412–420.

Saffari A, Brosse I, Wiemer-Kruel A, et al. Safety and efficacy of mTOR inhibitor treatment in patients with tuberous sclerosis complex under 2 years of age - a multicenter retrospective study. Orphanet J Rare Dis. 2019 May 3;14(1):96.

Kuki I, Kawawaki H, Okazaki S, et al. Efficacy and safety of everolimus in patients younger than 12months with congenital subependymal giant cell astrocytoma. Brain Dev. 2018 May;40(5):415–420.

Sugalska M, Tomik A, Jóźwiak S, Werner B. Treatment of Cardiac Rhabdomyomas with mTOR Inhibitors in Children with Tuberous Sclerosis Complex-A Systematic Review. Int J Environ Res Public Health. 2021 May 5;18(9):4907. doi: 10.3390/ijerph18094907. PMID: 34062963; PMCID: PMC8124908.

de Ribaupierre S, Dorfmüller G, Bulteau C, FohlenM, Pinard J-M, Chiron C, Delalande O (2007) Subependymal giant-cell astrocytomasin pediatric tuberous sclerosis disease. Neurosurgery 60(1):83–90

Day AM, McCulloch CE, Hammill AM, et al. Physical and family history variables associated with neurological and cognitive development in Sturge-Weber syndrome. Pediatr Neurol 2019;96:30–36

Higueros E, Roe E, Granell E, et al. Sturge-Weber syndrome: a review. Actas Dermosifiliogr 2017;108:407–417

Chapas AM, Eickhorst K, Geronemus RG. Efficacy of early treatment of facial port wine stains in newborns: a review of 49 cases. Lasers Surg Med 2007;39:563–568

Wen X, Li Y, Hamblin MR. Photodynamic therapy in dermatology beyond non-melanoma cancer: an update. Photodiagnosis Photodyn Ther 2017;19:140–152

Javaid U, Ali MH, Jamal S, et al. Pathophysiology, diagnosis, and management of glaucoma associated with Sturge-Weber syndrome. Int Ophthalmol 2018;38:409–416

Luat AF, Behen ME, Chugani HT, et al. Cognitive and motor outcomes in children with unilateral Sturge-Weber syndrome: effect of age at seizure onset and side of brain involvement. Epilepsy Behav 2018;80:202–207

Bosnyak E, Behen ME, Guy WC, et al. Predictors of cognitive functions in children with Sturge-Weber syndrome: a longitudinal study. Pediatr Neurol 2016;61:38–45

Vargha-Khadem F, Carr LJ, Isaacs E, et al. Onset of speech after left hemispherectomy in a nine-year-old boy. Brain 1997;120 (pt 1):159– 182

Sun B, Han T, Wang Y, Gao Q, Cui J, Shen W. Sirolimus as a Potential Treatment for Sturge-Weber Syndrome. J Craniofac Surg. 2021 Jan-Feb 01;32(1):257-260

Giacaman A, Salinas Sanz JA, Navarro Noguera S, Lastra Rodríguez J, Montis Palos MC, Martín-Santiago A. Facial hemihypertrophy in a girl with sturge-weber syndrome: Treatment with oral sirolimus. Pediatr Dermatol. 2021 Mar;38(2):469-471.

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18 Ocak 2023

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