Clival chordoma: a single-centre outcome analysis

Abstract

Our patients show a low rate of gross total resection but an outcome well comparable to other published results. This emphasises the importance of interdispiplinary treatment strategies, with surgery supplying maximal safe resection and avoiding severe neurological deficit, allowing patients to undergo adjusted radiotherapy and other treatment options in a good condition.

Molecular Targeted Therapy in the Treatment of Chordoma: A Systematic Review

“…Among 33 studies, nine studies were clinical trials (10–12, 14, 15, 19–22), with eight retrospective case series (16, 17, 23–28), and 16 case reports (13, 29–43). Imatinib was assessed in 18 studies with a total of 221 patients (10, 16, 17, 19, 23–28, 32, 34–36, 38, 39, 41, 42), erlotinib in 10 studies with 16 patients (13, 17, 22, 33, 35, 38, 40–42), cetuximab in five studies (seven patients) (13, 30, 31, 33, 41), sorafenib in four studies (65 patients) (15, 17, 21, 37), pazopanib in four studies with seven patients (16, 28, 41, 43) and sunitinib in three studies with 11 patients (14, 17, 28). Sirolimus, thalidomide, bevacizumab, gefitinib, linsitinib, and everolimus were accessed in two studies each (13, 22, 25, 28–31, 33, 34, 40–42), whereas dasatinib (32 patients) (11), lapatinib (18 patients) (12), rapamycin (one patients) (34), temosirolimus (one patients) (17) and yeast-brachyury (GI-6301) vaccine (11 patients) (20) were only analyzed in one study each (Figures 2 and 3).…”

“…RECIST evaluation criteria was used in 19 studies (10–15, 17, 19, 20, 22, 25–28, 32, 40, 42, 43, 45) and Choi's criteria is applied in three studies (11, 12, 25). Twenty-one studies were evaluated by clinical/radiological or metabolic responses (16, 23–27, 29–43). Adverse events (AEs) were reported in 25 studies, including hematological anomalies like anemia, thrombocytopenia, as well as non-hematological AEs like fatigue, fever, anorexia, QTc prolongation, abnormal liver function, nausea, and vomiting (10–15, 19, 22, 23, 26–38, 40, 43, 45).…”

“…Eighteen studies investigated the therapeutic efficacy of IM on 221 patients (10, 16, 17, 19, 23–28, 32, 34–36, 38, 39, 41, 42), including three clinical trials (10, 19, 28), seven retrospective case series (16, 17, 23–27), and eight case reports (32, 34–36, 38, 39, 41, 42). Fourteen studies (204 patients) analyzed the efficacy of imatinib as monotherapy (10, 16, 17, 23, 24, 26–28, 32, 34–36, 39, 41), of which four studies (181 patients) used RECIST and 3 were focused on PDGFRβ-expressing chordoma. In these four studies, four patients achieved partial response (PR) (2.2%), 133 cases sustained stable disease (SD) (73.5%) and 44 cases experienced progressive disease (PD) (24.3%) (10, 17, 26, 27, 32).…”

“…New insights into the molecular mechanism underlying chordoma have also identified novel therapeutic targets (5). Molecular targeted therapy (MTT) in chordoma includes (1) imatinib and dasatinib against platelet-derived growth factor receptors (PDGFR) and stem cell factor receptor (KIT) (10, 11); (2) erlotinib, lapatinib, gefitinib, and cetuximab against epidermal growth factor receptor (EGFR) and erbB-2/human epidermal growth factor receptor 2 (HER2/neu) (12, 13); (3) sorafenib, pazopanib, and sunitinib that target angiogenic factors like vascular endothelial growth factor receptor (VEGFR) (14–16); and (4) temsirolimus and sirolimus that target the phosphoinositide 3-kinase (PI3K)/AKT/mammalian target of rapamycin (mTOR) pathway (17).…”

Endoscopic endonasal transclival removal of tumors of the clivus and anterior region of the posterior cranial fossa (results of surgical treatment of 140 patients)

“…With the development of modern endoscopic techniques, more and more studies have started to emerge in the world literature regarding the experience of surgical removal of centrally located tumors of the base of the skull using the endoscopic transclival approach [10][11][12][13][14][15][16][17][18][19][20]. According to Sanmillan et al [15], the results of using the endoscopic transclival approach for the removal of central tumors of the skull base are comparable to the results of using various transcranial approaches, and in a number of cases, they are clearly superior.…”