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Alexander Drilon, MD

Gregory J. Riely, MD, PhD


Use of Entrectinib in Treatment of Malignant Glioneuronal Tumors: Case Report

By: Jenna Carter, PhD
Posted: Thursday, July 28, 2022

An article published in Neuro-Oncology Advances reported findings from a case study of a female Asian patient who was diagnosed with malignant glioneuronal tumors and treated with the TRK inhibitor entrectinib. Isao Date, MD, PhD, of Okayama University, Japan, and colleagues performed a battery of molecular analyses and follow-up MRIs to track tumor progression in this patient following tumor resection, radiation therapy, and entrectinib treatment.

This patient was a 14-year-old girl who initially presented with headaches. An MRI was performed, and two cystic lesions were detected. They were located bilaterally in the frontal areas with surrounding edema. The patient underwent surgery for removal of the larger left tumor and two separate left-frontal craniotomies. The patient also received extended local-field irradiation (60 Gy/30 fractions) and temozolomide (13 cycles in total), and pathologic examinations were used to diagnose the tumor type. She ultimately was diagnosed with high-grade glioneuronal tumors and vascular growth, with a 20% Ki67 index.

RNA sequencing revealed an ARHGEF2::NTRK1 fusion gene, which was confirmed by the cancer gene panel test. MRI follow-up after surgery revealed rapid tumor progression 2 years after the first operation. However, after entrectinib treatment, MRI follow-ups 1 and 3 months later showed a response: the lesion on the left disappeared and the lesion on the right shrank. The patient’s general fatigue became severe, so entrectinib dose reductions were necessary to mitigate adverse events. However, due to these dose reductions, MRI follow-up revealed tumor regrowth 6 months after starting administration of entrectinib.

Disclosure: The study authors reported no conflicts of interest.

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