Malignant peripheral nerve sheath tumors

Mohamad Farid, Elizabeth G. Demicco, Roberto Garcia, Linda Ahn, Pamela R. Merola, Angela Cioffi, Robert G. Maki

Research output: Contribution to journalArticlepeer-review

200 Scopus citations

Abstract

Malignant peripheral nerve sheath tumors (MPNST) are uncommon, biologically aggressive soft tissue sarcomas of neural origin that pose tremendous challenges to effective therapy. In 50% of cases,they occur in the context of neurofibromatosis type I, characterized by loss of function mutations to the tumor suppressor neurofibromin; the remainder arise sporadically or following radiation therapy. Prognosis is generally poor, with high rates of relapse following multimodality therapy in early disease, low response rates to cytotoxic chemotherapy in advanced disease, and propensity for rapid disease progression and highmortality. The last few years have seen an explosion in data surrounding the potentialmolecular drivers and targets for therapy above and beyond neurofibromin loss. These data span multiple nodes at various levels of cellular control, including major signal transduction pathways, angiogenesis, apoptosis, mitosis, and epigenetics. These include classical cancer-driving genetic aberrations such as TP53 and phosphatase and tensin homolog (PTEN) loss of function, and upregulation of mitogenactivated protein kinase (MAPK) and (mechanistic) target of rapamycin (TOR) pathways, aswell as less ubiquitousmolecular abnormalities involving inhibitors of apoptosis proteins, aurora kinases, and the Wingless/int (Wnt) signaling pathway. We review the current understanding of MPNST biology, current best practices of management, and recent research developments in this disease, with a view to informing future advancements in patient care.

Original languageEnglish
Pages (from-to)193-201
Number of pages9
JournalOncologist
Volume19
Issue number2
DOIs
StatePublished - 2014

Keywords

  • Clinical trials
  • Malignant peripheral nerve sheath tumor
  • Molecular targeted therapy
  • Neurofibromatosis type 1
  • Sarcoma

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