Craniopharyngioma medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Marjan Khan M.B.B.S.[2]

Overview

The predominant therapy for craniopharyngioma is surgical resection. Adjunctive chemotherapy and radiation may be required. Subcutaneous pegylated interferon alpha-2b has been used to treat cystic recurrences. It can also be treated with intracavitary instillation of radioactive P-32, bleomycin or interferon-alpha via stereotactic delivery or placement of an Ommaya catheter. Paclitaxel and carboplatin have shown to prevent recurrence of malignant craniopharyngiomas.

Medical Therapy

• Although the mainstay of therapy for craniopharyngioma is surgery with or without radiation, there are certain indications for medical therapy as well, mostly in treating recurrent tumors.
• Although systemic therapy is generally not utilized, it has been shown that the use of subcutaneous pegylated interferon alpha-2b to manage cystic recurrences can result in durable responses.
• The chemotherapy drugs Paclitaxel and Carboplatin have shown a clinical (but not statistical) significance in increasing the survival rate in patients who've had gross total resections of their malignant tumors.
• Cystic recurrences may be treated with intracavitary instillation of varying agents via stereotactic delivery or placement of an Ommaya catheter. These agents have included radioactive P-32 or other radioactive compounds, bleomycin or interferon-alpha. These strategies have been found to be useful in certain cases, and a low risk of complications has been reported. However, none of these approaches have shown efficacy against solid portions of the tumor.
• The following is an example of a national and/or institutional phase II clinical trial that is currently being conducted. PBTC-039 (NCT01964300) (Peginterferon Alpha-2b) in treating younger patients with craniopharyngioma that is recurrent or cannot be removed by surgery.

References

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