A Case of High Grade Glioma Following Treatment of Relapsing-Remitting Multiple Sclerosis with Fingolimod

Erbay, Mehmet Fatih; Kamışlı, Özden

doi:10.4103/0028-3886.284361

Cited by 5 publications

(2 citation statements)

References 13 publications

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“…While 4-HPR has shown promise in vitro, its poor solubility and bioavailability have limited its use clinically, with both of the glioma clinical trials showing no improvement in progression-free survival at the doses administered (Table 2) [175,177]. Intriguingly, there have been reports of multiple sclerosis patients treated with fingolimod that later developed high grade gliomas [178]. The mechanism behind this etiology is unclear, but possibly linked to the immunosuppression or activation of additional S1P receptors.…”

Section: Glioblastomamentioning

confidence: 99%

Sphingolipid Metabolism in Glioblastoma and Metastatic Brain Tumors: A Review of Sphingomyelinases and Sphingosine-1-Phosphate

et al. 2020

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Glioblastoma (GBM) is a primary malignant brain tumor with a dismal prognosis, partially due to our inability to completely remove and kill all GBM cells. Rapid tumor recurrence contributes to a median survival of only 15 months with the current standard of care which includes maximal surgical resection, radiation, and temozolomide (TMZ), a blood–brain barrier (BBB) penetrant chemotherapy. Radiation and TMZ cause sphingomyelinases (SMase) to hydrolyze sphingomyelins to generate ceramides, which induce apoptosis. However, cells can evade apoptosis by converting ceramides to sphingosine-1-phosphate (S1P). S1P has been implicated in a wide range of cancers including GBM. Upregulation of S1P has been linked to the proliferation and invasion of GBM and other cancers that display a propensity for brain metastasis. To mediate their biological effects, SMases and S1P modulate signaling via phospholipase C (PLC) and phospholipase D (PLD). In addition, both SMase and S1P may alter the integrity of the BBB leading to infiltration of tumor-promoting immune populations. SMase activity has been associated with tumor evasion of the immune system, while S1P creates a gradient for trafficking of innate and adaptive immune cells. This review will explore the role of sphingolipid metabolism and pharmacological interventions in GBM and metastatic brain tumors with a focus on SMase and S1P.

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Section: Glioblastomamentioning

confidence: 99%

Sphingolipid Metabolism in Glioblastoma and Metastatic Brain Tumors: A Review of Sphingomyelinases and Sphingosine-1-Phosphate

et al. 2020

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“…Concurrent diagnosis of GBM and MS is uncommon and not systematically studied to date [10]. Several case reports of MS patients with brain tumors, including GBM, were published [11][12][13][14][15][16][17][18]. However, to our knowledge, there is no report of an MS patient with GBM being treated with TTFields yet.…”

Section: Introductionmentioning

confidence: 99%

First Report of Tumor Treating Fields (TTFields) Therapy for Glioblastoma in Comorbidity with Multiple Sclerosis

Kassubek

Mathieu

2022

Brain Sciences

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Tumor Treating Fields (TTFields) therapy is FDA approved and has the CE mark for treatment of newly diagnosed and recurrent glioblastoma. To our knowledge, to date TTFields therapy remains unstudied in glioblastoma patients with multiple sclerosis (MS) as a comorbidity. Here, we present a patient who was diagnosed with MS at the age of 34. Treatment included several corticoid pulse treatments and therapies with interferon beta-1a and sphingosine-1-phosphate receptor modulator fingolimod. At the age of 52 the patient was diagnosed with glioblastoma, after experiencing worsening headaches which could not be attributed to the MS condition. After subtotal resection and concomitant radiochemotherapy, the patient received temozolomide in combination with TTFields therapy. For two years, the tumor condition remained stable while the patient showed high adherence to TTFields therapy with low-grade skin reactions being the only therapy-related adverse events. After two years, the tumor recurred. The patient underwent re-resection and radiotherapy and restarted TTFields therapy together with chemotherapy and is currently still on this therapy regime. Although having not been studied systematically, the case presented here demonstrates that TTFields therapy may be considered for newly diagnosed and recurrent glioblastoma patients with previously diagnosed multiple sclerosis.

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Fingolimod

2020

Reactions Weekly

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A Case of High Grade Glioma Following Treatment of Relapsing-Remitting Multiple Sclerosis with Fingolimod

Cited by 5 publications

References 13 publications

Sphingolipid Metabolism in Glioblastoma and Metastatic Brain Tumors: A Review of Sphingomyelinases and Sphingosine-1-Phosphate

Sphingolipid Metabolism in Glioblastoma and Metastatic Brain Tumors: A Review of Sphingomyelinases and Sphingosine-1-Phosphate

First Report of Tumor Treating Fields (TTFields) Therapy for Glioblastoma in Comorbidity with Multiple Sclerosis

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