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Targeted Therapies for Pediatric Nervous System Tumors

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Pediatric Oncology".

Deadline for manuscript submissions: 31 October 2026 | Viewed by 1792

Special Issue Editors


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Guest Editor
Department of Pediatrics, The Division of Hematology and Oncology, St. Louis Children's Hospital, Washington University School of Medicine in St. Louis, St. Louis, MI, USA
Interests: pediatric low-grade gliomas; cell therapy for brain tumors; CNS germ cell tumors

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Guest Editor
Department of Pediatrics, The Division of Hematology and Oncology, Washington University School of Medicine, Saint Louis, MI, USA
Interests: neurofibromatosis type 1 (NF1); obesity; diet; pediatric low-grade gliomas

Special Issue Information

Dear Colleagues,

Brain tumors have surpassed leukemia to become the most common neoplasm in the pediatric population, representing a major source of morbidity and mortality. Peripheral nervous system tumors, while less common than brain tumors in the pediatric population, have also been noted as clinically challenging. While traditional therapeutic interventions, including surgical resection followed by chemotherapy and/or radiation therapy, have improved survival rates for many pediatric nervous system tumors, they have been associated with significant long-term side effects. Furthermore, patients with certain tumor types still face dismal outcomes. Consequently, targeted therapeutic agents have been investigated across almost all pediatric nervous system tumors, which has led to impressive responses in some tumors and disappointing results in others. This Special Issue will focus on the current role of targeted therapies in managing pediatric nervous system tumors, as well as alternative approaches that are still under investigation.

Dr. Mohamed S. Abdelbaki
Dr. Nicole Brossier
Guest Editors

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Keywords

  • glioma
  • ependymoma
  • medulloblastoma
  • pediatric brain tumors
  • targeted therapy
  • MEK inhibitors
  • NTRK inhibitors
  • glioma neuroscience
  • diffuse intrinsic pontine glioma

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Published Papers (2 papers)

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Research

22 pages, 8790 KB  
Article
Ex Vivo Characterization Studies Identify Candidate Therapies for the Individualized Care of NF2-Related Schwannomatosis
by Ethan W. Hass, Anna Nagel, Alexandra J. Scott, Robert Allaway, Haley M. Hardin, Hollie M. Hayes, Lenna Huelbes, Alexander W. Sutton, Sofia A. Oliveira, Michelle Pei, Fred F. Telischi, John Ragheb, McKay McKinnon, Ziad Khatib, Mislen Bauer, Christine T. Dinh and Cristina Fernandez-Valle
Cancers 2026, 18(8), 1209; https://doi.org/10.3390/cancers18081209 - 10 Apr 2026
Viewed by 531
Abstract
Background/Objectives: NF2-related schwannomatosis (NF2-SWN) is a genetic tumor predisposition syndrome of the nervous system caused by pathogenic variants in NF2 encoding the merlin tumor suppressor. Truncating variants in NF2 cause severe phenotypes with higher tumor burden, early mortality, and [...] Read more.
Background/Objectives: NF2-related schwannomatosis (NF2-SWN) is a genetic tumor predisposition syndrome of the nervous system caused by pathogenic variants in NF2 encoding the merlin tumor suppressor. Truncating variants in NF2 cause severe phenotypes with higher tumor burden, early mortality, and a lifetime need for multiple surgeries due to lack of medications that control schwannoma growth. Methods: We developed a functional precision medicine (FPM)-inspired workflow to identify drug sensitivities in cells isolated from a pediatric severe NF2-SWN patient’s spinal and peripheral schwannomas. Transcriptomic profiling, high-content drug sensitivity assays, tissue and isolated cell immunostaining, flow cytometry, and capillary-based immunoblotting were used to study the available tissues. Results: Aberrant merlin-dependent pathway expression was conserved between the spinal schwannoma and its cultured primary cells. Drug sensitivity screens in 2- and 3-dimensional formats revealed cytotoxic effects of fimepinostat in primary cells; dasatinib with brigatinib was the most effective cytostatic combination. Ineffective therapies attempted in the patient were also ineffective ex vivo. Conclusions: These data support the idea of using the FPM workflow to improve and individualize the standard of care for severe NF2-SWN patients using surgical samples. Full article
(This article belongs to the Special Issue Targeted Therapies for Pediatric Nervous System Tumors)
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15 pages, 4056 KB  
Communication
Trametinib and Fimepinostat Induce Malignant Peripheral Nerve Sheath Tumor Cell Death In Vitro
by Ethan W. Hass, Sofia A. Oliveira and Cristina Fernandez-Valle
Cancers 2026, 18(5), 746; https://doi.org/10.3390/cancers18050746 - 26 Feb 2026
Viewed by 687
Abstract
Background/Objectives: Neurofibromatosis Type 1 (NF1) is a genetic syndrome caused by pathogenic NF1 variants encoding neurofibromin, a Ras GTPase activating protein. Individuals with NF1 develop peripheral nerve sheath tumors called neurofibromas. Approximately 50% of NF1 patients develop plexiform neurofibromas (pNFs) which have up [...] Read more.
Background/Objectives: Neurofibromatosis Type 1 (NF1) is a genetic syndrome caused by pathogenic NF1 variants encoding neurofibromin, a Ras GTPase activating protein. Individuals with NF1 develop peripheral nerve sheath tumors called neurofibromas. Approximately 50% of NF1 patients develop plexiform neurofibromas (pNFs) which have up to 13% lifetime risk of transformation into malignant peripheral nerve sheath tumors (MPNSTs). Current therapeutic strategies emphasize surgical resection with wide margins, radiation, and traditional chemotherapy for unresectable MPNSTs. However, NF1 patients diagnosed with MPNSTs have 5-year survival rates as low as 16%. The two recently FDA-approved drugs for pNFs, the MEK inhibitors selumetinib and mirdametinib, are not used to prevent or treat MPNSTs. Methods: The MEK inhibitor trametinib and the dual HDAC/PI3K inhibitor fimepinostat were assessed for growth inhibitory effects in nine unique patient-derived MPNST cell lines, as both drugs have preclinical efficacy in other Schwann cell-derived tumors. Results: Trametinib, which is approved for malignant melanomas, promoted cell death in 7/9 MPNST cell lines with a geometric mean GI50 = 17 nM. When directly compared to selumetinib and mirdametinib in a subset of four MPNST cell lines, trametinib had the lowest mean GI50 (trametinib = 38 nM, mirdametinib = 1.6 µM, selumetinib = 4.9 µM). Trametinib was also superior to selumetinib and mirdametinib in blocking ERK1/2 phosphorylation for 24 h. Fimepinostat promoted cell death in all cell lines with a geometric mean GI50 = 17 pM. Conclusions: These studies demonstrate in vitro efficacy for two candidate MPNST therapeutics which could reduce tumor burden and metastasis in NF1 patients. Full article
(This article belongs to the Special Issue Targeted Therapies for Pediatric Nervous System Tumors)
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