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The Molecular Mechanism and Therapeutic Progress in Glomus Tumor
Zhi Cheng Jiang1, Zu Jue Cheng1, Jue Xian Xiao1
1Department of Neurosurgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
Background:
Glomus tumor (GT) is a rare mesenchymal neoplasm presumed to originate from the neuromyoarterial glomus body. Its pathogenesis is complex and involves alterations in multiple genes and signaling pathways. In the era of precision medicine, increased molecular research has begun to elucidate the oncogenic drivers of GT, offering novel potential directions for targeted treatment strategies.
Methods:
This article provides a focused narrative review, synthesizing recent peer-reviewed literature on the molecular genetics and clinical management of GT. Key findings from genetic studies, preclinical models, and clinical reports from recent years are summarized and analyzed.
Results:
Molecular studies have identified recurrent genetic alterations underpinning GT pathogenesis. Key discoveries include frequent inactivating mutations in the NF1 gene, leading to constitutive RAS/MAPK pathway activation, and recurrent "MIR143-NOTCH" gene fusions disrupting Notch signaling and so on. These drivers present potential therapeutic targets. While complete surgical excision remains the standard curative treatment for localized disease, molecular insights have spurred investigation into targeted agents, including MEK inhibitors for NF1-deficient tumors and immunotherapy. Such systemic therapies are particularly relevant for multifocal, metastatic, or surgically challenging cases.
Conclusion:
The integration of molecular profiling is refining the understanding of GT biology and expanding its therapeutic landscape. Moving beyond traditional surgery, the identification of targetable genetic alterations paves the way for personalized medicine approaches. Future efforts should focus on validating biomarkers in clinical trials to establish effective targeted therapies, ultimately improving outcomes for patients with complex or advanced GTs.
Insights
Glomus tumors (GTs) involve genetic changes like NF1 mutations and MIR143-NOTCH fusions. Molecular insights are guiding new targeted therapies beyond surgery for complex GT cases.
Area of Science:
- Oncology
- Molecular Genetics
Background:
- Glomus tumors (GTs) are rare mesenchymal neoplasms with complex pathogenesis.
- Understanding GT oncogenic drivers is crucial for precision medicine.
Purpose of the Study:
- To review molecular genetics and clinical management of GTs.
- To synthesize recent findings on GT pathogenesis and therapeutic targets.
Main Methods:
- Focused narrative review of peer-reviewed literature.
- Analysis of genetic studies, preclinical models, and clinical reports.
Main Results:
- Identified recurrent genetic alterations in GTs, including NF1 gene mutations and MIR143-NOTCH fusions.
- These alterations activate signaling pathways like RAS/MAPK and Notch.
- Targeted agents (e.g., MEK inhibitors, immunotherapy) show promise for advanced GTs.
Conclusions:
- Molecular profiling enhances understanding of GT biology and treatment options.
- Targetable genetic alterations enable personalized medicine approaches for GTs.
- Clinical trials are needed to validate biomarkers and establish targeted therapies for complex GTs.
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