Profound clinical and radiological response to BRAF inhibition in a 2-month-old diencephalic child with hypothalamic/chiasmatic glioma

Pediatr Blood Cancer. 2016 Nov;63(11):2038-41. doi: 10.1002/pbc.26086. Epub 2016 Jul 11.

Abstract

Infants with low-grade glioma (LGG) have a poor survival. BRAFV600E mutation has been identified in pediatric LGG; however, the use of BRAF inhibitors in infants has never been reported. A 2-month-old with V600E mutant hypothalamic/chiasmatic glioma progressed on chemotherapy resulting in profound visual loss, massive ascites, and diencephalic syndrome. Initiation of dabrafenib resulted in rapid and sustained disappearance of clinical symptoms and a profound sustained cytoreduction. BRAF inhibition was safely tolerated with dramatic clinicoradiological response, suggesting early targeted therapy is a viable option in infants with LGG. A re-evaluation of current management paradigms in this population is warranted to leverage the potential benefit of upfront-targeted therapies.

Keywords: dabrafenib; glioma; hypothalamic-chiasmatic; infant; low grade.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Brain Neoplasms / diagnostic imaging
  • Brain Neoplasms / drug therapy*
  • Female
  • Glioma / diagnostic imaging
  • Glioma / drug therapy*
  • Humans
  • Hypothalamic Diseases / drug therapy*
  • Infant
  • Magnetic Resonance Imaging
  • Proto-Oncogene Proteins B-raf / antagonists & inhibitors*

Substances

  • Proto-Oncogene Proteins B-raf