title: ENDOCRINE TUMORS: BRAF V600E mutations in papillary craniopharyngioma.
abstract: Papillary craniopharyngioma (PCP) is an intracranial tumor that results in high levels of morbidity. We recently demonstrated that the vast majority of these tumors harbor the oncogenic BRAF V600E mutation. The pathologic diagnosis of PCP can now be confirmed using mutation specific immunohistochemistry and targeted genetic testing. Treatment with targeted agents is now also a possibility in select situations. We recently reported a patient with a multiply recurrent PCP in whom targeting both BRAF and MEK resulted in a dramatic therapeutic response with a marked anti-tumor immune response. This work shows that activation of the MAPK pathway is the likely principal oncogenic driver of these tumors. We will now investigate the efficacy of this approach in a multicenter phase II clinical trial. Post-treatment resection samples will be monitored for the emergence of resistance mechanisms. Further advances in the non-invasive diagnosis of PCP by radiologic criteria and by cell-free DNA testing could someday allow neo-adjuvant therapy for this disease in select patient populations.
authors.affiliation: Division of Neuro-OncologyMassachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USADepartment of Cancer BiologyDana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts 02215, USADepartment of PathologyBrigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, 77 Avenue Louis Pasteur, Boston, Massachusetts 02115, USADepartment of PathologyBoston Children's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA.
authors.forename: Priscilla K
authors.initials: PK
authors.lastname: Brastianos
authors.affiliation: Division of Neuro-OncologyMassachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USADepartment of Cancer BiologyDana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts 02215, USADepartment of PathologyBrigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, 77 Avenue Louis Pasteur, Boston, Massachusetts 02115, USADepartment of PathologyBoston Children's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA Division of Neuro-OncologyMassachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USADepartment of Cancer BiologyDana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts 02215, USADepartment of PathologyBrigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, 77 Avenue Louis Pasteur, Boston, Massachusetts 02115, USADepartment of PathologyBoston Children's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA Division of Neuro-OncologyMassachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USADepartment of Cancer BiologyDana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts 02215, USADepartment of PathologyBrigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, 77 Avenue Louis Pasteur, Boston, Massachusetts 02115, USADepartment of PathologyBoston Children's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA ssantagata@bics.bwh.harvard.edu.
authors.forename: Sandro
authors.initials: S
authors.lastname: Santagata
mesh_terms: D002291:Carcinoma, Papillary / Q000175:diagnosis / Q000235:genetics* / Q000473:pathology; D017322:Clinical Trials, Phase II as Topic; D003397:Craniopharyngioma / Q000175:diagnosis / Q000235:genetics* / Q000473:pathology; D004701:Endocrine Gland Neoplasms / Q000175:diagnosis / Q000235:genetics / Q000473:pathology; D018698:Glutamic Acid / Q000235:genetics; D006801:Humans; D020935:MAP Kinase Signaling System / Q000235:genetics; D010911:Pituitary Neoplasms / Q000175:diagnosis / Q000235:genetics* / Q000473:pathology; D017354:Point Mutation; D048493:Proto-Oncogene Proteins B-raf / Q000235:genetics*; D014633:Valine / Q000235:genetics
chemical_list: D018698:Glutamic Acid; C482119:BRAF protein, human; D048493:Proto-Oncogene Proteins B-raf; D014633:Valine