MÚDRY, Peter, Ondřej SLABÝ, Jakub NERADIL, Jana ŠOUKALOVÁ, Kristýna MELICHÁRKOVÁ, Ondřej ROHLEDER, Marta JEŽOVÁ, Anna SEEHOFNEROVÁ, Elleni PONECHAL MICHU, Renata VESELSKÁ and Jaroslav ŠTĚRBA. Case report: rapid and durable response to PDGFR targeted therapy in a child with refractory multiple infantile myofibromatosis and a heterozygous germline mutation of the PDGFRB gene. BMC Cancer. London, UK: BioMed Central, 2017, vol. 17, No 119, p. nestránkováno, 7 pp. ISSN 1471-2407. Available from: https://dx.doi.org/10.1186/s12885-017-3115-x.
Other formats:   BibTeX LaTeX RIS
Basic information
Original name Case report: rapid and durable response to PDGFR targeted therapy in a child with refractory multiple infantile myofibromatosis and a heterozygous germline mutation of the PDGFRB gene
Authors MÚDRY, Peter (203 Czech Republic, belonging to the institution), Ondřej SLABÝ (203 Czech Republic, belonging to the institution), Jakub NERADIL (203 Czech Republic, belonging to the institution), Jana ŠOUKALOVÁ (203 Czech Republic, belonging to the institution), Kristýna MELICHÁRKOVÁ (203 Czech Republic, belonging to the institution), Ondřej ROHLEDER (203 Czech Republic, belonging to the institution), Marta JEŽOVÁ (203 Czech Republic, belonging to the institution), Anna SEEHOFNEROVÁ (203 Czech Republic, belonging to the institution), Elleni PONECHAL MICHU (203 Czech Republic, belonging to the institution), Renata VESELSKÁ (203 Czech Republic, belonging to the institution) and Jaroslav ŠTĚRBA (203 Czech Republic, guarantor, belonging to the institution).
Edition BMC Cancer, London, UK, BioMed Central, 2017, 1471-2407.
Other information
Original language English
Type of outcome Article in a journal
Field of Study 30200 3.2 Clinical medicine
Country of publisher United Kingdom of Great Britain and Northern Ireland
Confidentiality degree is not subject to a state or trade secret
WWW URL
Impact factor Impact factor: 3.288
RIV identification code RIV/00216224:14110/17:00095701
Organization unit Faculty of Medicine
Doi http://dx.doi.org/10.1186/s12885-017-3115-x
UT WoS 000393842000001
Keywords in English Infantile myofibromatosis; tyrosine kinase inhibitor; PDGFR; chemotherapy; theranostics; case report
Tags International impact, Reviewed
Changed by Changed by: Mgr. Tereza Miškechová, učo 341652. Changed: 27/1/2021 14:40.
Abstract
Infantile myofibromatosis belongs to a family of soft tissue tumors. The majority of these tumors have benign behavior but resistant and malignant courses are known, namely in tumors with visceral involvement. The standard of care is surgical resection. Observations suggest that low dose chemotherapy is beneficial. The treatment of resistant or relapsed patients with multifocal disease remains challenging. Patients that harbor an actionable mutation in the kinase domain are potential subjects for targeted tyrosine kinase inhibitor therapy. An infant boy with inborn generalized infantile myofibromatosis that included bone, intracranial, soft tissue and visceral involvement was treated according to recent recommendations with low dose chemotherapy. The presence of a partial but temporary response led to a second line of treatment with six cycles of chemotherapy, which achieved a partial response again but was followed by severe toxicity. The generalized progression of the disease was observed later. Genetic analyses were performed and revealed a PDGFRB gene c. 1681C>A missense heterozygous germline mutation, high PDGFR beta phosphokinase activity within the tumor and the heterozygous germline Slavic Nijmegen breakage syndrome 657del5 mutation in the NBN gene. Targeted treatment with sunitinib, the PDGFR beta inhibitor, plus low dose vinblastine led to an unexpected and durable response without toxicities or limitations to daily life activities. The presence of the Slavic NBN gene mutation limited standard chemotherapy dosing due to severe toxicities. Sister of the patient suffred from skull base tumor with same genotype and histology. The same targeted therapy led to similar quick and durable response. Progressive and resistant incurable infantile myofibromatosis can be successfully treated with the new approach described herein. Detailed insights into the biology of the patient's tumor and genome are necessary to understand the mechanisms of activity of less toxic and effective drugs except for up to date population-based chemotherapy regimens.
Links
LM2015090, research and development projectName: Český národní uzel Evropské sítě infrastruktur klinického výzkumu (Acronym: CZECRIN)
Investor: Ministry of Education, Youth and Sports of the CR
NV16-33209A, research and development projectName: Sekvenování nové generace a expresní profilování jako diagnostický podklad pro návrhy individualizovaných léčebných plánů pro děti se solidními nádory
NV16-34083A, research and development projectName: Receptorové tyrozinkinázy a navazující signální dráhy jako potenciální cíle léčby refrakterních solidních nádorů dětského věku
PrintDisplayed: 9/9/2024 02:19