[Craniopharyngioma : Current Perspectives Including Recent Advances in Molecular Targeted Therapy].

Area of Science:

• Neuro-oncology
• Endocrinology
• Neurosurgery

Background:

• Craniopharyngiomas are benign tumors near critical brain structures, posing treatment challenges.
• Recent discoveries of driver mutations (CTNNB1, BRAF V600E) are revolutionizing treatment approaches.
• Minimally invasive endoscopic endonasal surgery is increasingly indicated.

Purpose of the Study:

• To review current and emerging treatment strategies for craniopharyngiomas.
• To highlight the impact of molecular subtypes on therapeutic decisions.
• To emphasize a multimodal and individualized approach to patient care.

Main Methods:

• Review of recent advancements in surgical techniques, radiotherapy, and molecular targeted therapy.
• Integration of molecular findings (CTNNB1, BRAF V600E) into treatment planning.
• Discussion of individualized, multimodal treatment strategies.

Main Results:

• Endoscopic endonasal surgery is a key minimally invasive approach.
• Radiotherapy is effective for residual or recurrent tumors.
• BRAF and MEK inhibitors show significant efficacy in BRAF V600E-mutated papillary craniopharyngiomas, with potential neoadjuvant use.

Conclusions:

• Future craniopharyngioma management requires an individualized, multimodal approach.
• Treatment should balance tumor control with functional outcomes and quality of life.
• Molecular subtype, age, and functional status are crucial factors in decision-making.