A Critical Overview of Targeted Therapies for Vestibular Schwannoma
Vestibular schwannoma (VS) is a benign tumor that originates from Schwann cells in the vestibular component. Surgical treatment for VS has gradually declined over the past few decades, especially for small tumors. Gamma knife radiosurgery has become an accepted treatment for VS, with a high rate of...
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-05-01
|
| Series: | International Journal of Molecular Sciences |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1422-0067/23/10/5462 |
| _version_ | 1797499240538177536 |
|---|---|
| author | Ryota Tamura Masahiro Toda |
| author_facet | Ryota Tamura Masahiro Toda |
| author_sort | Ryota Tamura |
| collection | DOAJ |
| description | Vestibular schwannoma (VS) is a benign tumor that originates from Schwann cells in the vestibular component. Surgical treatment for VS has gradually declined over the past few decades, especially for small tumors. Gamma knife radiosurgery has become an accepted treatment for VS, with a high rate of tumor control. For neurofibromatosis type 2 (NF2)-associated VS resistant to radiotherapy, vascular endothelial growth factor (VEGF)-A/VEGF receptor (VEGFR)-targeted therapy (e.g., bevacizumab) may become the first-line therapy. Recently, a clinical trial using a VEGFR1/2 peptide vaccine was also conducted in patients with progressive NF2-associated schwannomas, which was the first immunotherapeutic approach for NF2 patients. Targeted therapies for the gene product of SH3PXD2A-HTRA1 fusion may be effective for sporadic VS. Several protein kinase inhibitors could be supportive to prevent tumor progression because merlin inhibits signaling by tyrosine receptor kinases and the activation of downstream pathways, including the Ras/Raf/MEK/ERK and PI3K/Akt/mTORC1 pathways. Tumor-microenvironment-targeted therapy may be supportive for the mainstays of management. The tumor-associated macrophage is the major component of immunosuppressive cells in schwannomas. Here, we present a critical overview of targeted therapies for VS. Multimodal therapy is required to manage patients with refractory VS. |
| first_indexed | 2024-03-10T03:44:38Z |
| format | Article |
| id | doaj.art-9f8f603758fb4a21be7d71a63f98c6d4 |
| institution | Directory Open Access Journal |
| issn | 1661-6596 1422-0067 |
| language | English |
| last_indexed | 2024-03-10T03:44:38Z |
| publishDate | 2022-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | International Journal of Molecular Sciences |
| spelling | doaj.art-9f8f603758fb4a21be7d71a63f98c6d42023-11-23T11:22:58ZengMDPI AGInternational Journal of Molecular Sciences1661-65961422-00672022-05-012310546210.3390/ijms23105462A Critical Overview of Targeted Therapies for Vestibular SchwannomaRyota Tamura0Masahiro Toda1Department of Neurosurgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, JapanDepartment of Neurosurgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, JapanVestibular schwannoma (VS) is a benign tumor that originates from Schwann cells in the vestibular component. Surgical treatment for VS has gradually declined over the past few decades, especially for small tumors. Gamma knife radiosurgery has become an accepted treatment for VS, with a high rate of tumor control. For neurofibromatosis type 2 (NF2)-associated VS resistant to radiotherapy, vascular endothelial growth factor (VEGF)-A/VEGF receptor (VEGFR)-targeted therapy (e.g., bevacizumab) may become the first-line therapy. Recently, a clinical trial using a VEGFR1/2 peptide vaccine was also conducted in patients with progressive NF2-associated schwannomas, which was the first immunotherapeutic approach for NF2 patients. Targeted therapies for the gene product of SH3PXD2A-HTRA1 fusion may be effective for sporadic VS. Several protein kinase inhibitors could be supportive to prevent tumor progression because merlin inhibits signaling by tyrosine receptor kinases and the activation of downstream pathways, including the Ras/Raf/MEK/ERK and PI3K/Akt/mTORC1 pathways. Tumor-microenvironment-targeted therapy may be supportive for the mainstays of management. The tumor-associated macrophage is the major component of immunosuppressive cells in schwannomas. Here, we present a critical overview of targeted therapies for VS. Multimodal therapy is required to manage patients with refractory VS.https://www.mdpi.com/1422-0067/23/10/5462schwannomaNF2bevacizumabVEGFSH3PXD2A-HTRA1 fusionmolecular targeted therapy |
| spellingShingle | Ryota Tamura Masahiro Toda A Critical Overview of Targeted Therapies for Vestibular Schwannoma International Journal of Molecular Sciences schwannoma NF2 bevacizumab VEGF SH3PXD2A-HTRA1 fusion molecular targeted therapy |
| title | A Critical Overview of Targeted Therapies for Vestibular Schwannoma |
| title_full | A Critical Overview of Targeted Therapies for Vestibular Schwannoma |
| title_fullStr | A Critical Overview of Targeted Therapies for Vestibular Schwannoma |
| title_full_unstemmed | A Critical Overview of Targeted Therapies for Vestibular Schwannoma |
| title_short | A Critical Overview of Targeted Therapies for Vestibular Schwannoma |
| title_sort | critical overview of targeted therapies for vestibular schwannoma |
| topic | schwannoma NF2 bevacizumab VEGF SH3PXD2A-HTRA1 fusion molecular targeted therapy |
| url | https://www.mdpi.com/1422-0067/23/10/5462 |
| work_keys_str_mv | AT ryotatamura acriticaloverviewoftargetedtherapiesforvestibularschwannoma AT masahirotoda acriticaloverviewoftargetedtherapiesforvestibularschwannoma AT ryotatamura criticaloverviewoftargetedtherapiesforvestibularschwannoma AT masahirotoda criticaloverviewoftargetedtherapiesforvestibularschwannoma |