Nimg-64. a Clinical Rule for Preoperative Prediction of Braf Mutation Status in Craniopharyngiomas
Year: 2018
Type: conference-abstract
Abstract: Papillary craniopharyngiomas are characterized by BRAF V600E mutations. Targeted therapy can elicit a dramatic radiographic regression of these tumors. Therefore, prediction of BRAF mutation status before definitive surgery could enable neoadjuvant treatment strategies. The aim of this study was to establish preoperative prediction criteria to identify patients with a BRAF mutant craniopharyngioma. Sixty-four patients with craniopharyngioma were included in this study. We determined BRAF mutation status by targeted sequencing. After scoring inter-observer variability between pre-surgical clinical data and radiographic features, we established a diagnostic rule for BRAF mutation in our discovery cohort. We then validated the rule in an independent cohort. The BRAF V600E mutation was detected in 12 of 42 patients in the discovery cohort. There were no patients under age 18 with BRAF mutation. Calcification was rare in tumors with BRAF mutation (P < .001), and 92% of them were supradiaphragmatic in location. Combining these three features older than 18 years, absence of calcification, and supradiaphragmatic tumor location we established a rule for predicting BRAF mutation. In cases where all three criteria were fulfilled, the sensitivity and specificity for the presence of BRAF mutation was 83% and 93%, respectively. In the validation cohort (n=22), the sensitivity was 100% and specificity was 89%. We propose predictive criteria for a BRAF mutation in craniopharyngioma using preoperative clinical and radiographic data. This rule may be useful in identifying patients who could potentially benefit from neoadjuvant BRAF V600E targeted systemic therapies.
Source: Neuro-Oncology
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2899608998