Neurofibromatosis type 1: New developments in genetics and treatment

J Am Acad Dermatol. 2021 Jun;84(6):1667-1676. doi: 10.1016/j.jaad.2020.07.105. Epub 2020 Aug 6.

Abstract

Neurofibromatosis type 1 is the most common neurocutaneous syndrome, with a frequency of 1 in 2500 persons. Diagnosis is paramount in the pretumor stage to provide proper anticipatory guidance for a number of neoplasms, both benign and malignant. Loss-of-function mutations in the NF1 gene result in truncated and nonfunctional production of neurofibromin, a tumor suppressor protein involved in downregulating the RAS signaling pathway. New therapeutic and preventive options include tyrosine kinase inhibitors, mTOR inhibitors, interferons, and radiofrequency therapy. This review summarizes recent updates in genetics, mutation analysis assays, and treatment options targeting aberrant genetic pathways. We also propose modified diagnostic criteria and provide an algorithm for surveillance of patients with neurofibromatosis type 1.

Keywords: RAS; interferon; mTOR inhibitor; mutation analysis; neurofibromatosis; radiofrequency therapy; tyrosine kinase inhibitor.

Publication types

  • Review

MeSH terms

  • Combined Modality Therapy / methods
  • DNA Mutational Analysis
  • Diagnosis, Differential
  • Humans
  • Loss of Function Mutation
  • Neurofibromatosis 1 / diagnosis*
  • Neurofibromatosis 1 / genetics
  • Neurofibromatosis 1 / therapy
  • Neurofibromin 1 / genetics*
  • Neurofibromin 1 / metabolism
  • Protein Kinase Inhibitors / pharmacology
  • Protein Kinase Inhibitors / therapeutic use*
  • Radiofrequency Therapy / methods*
  • Signal Transduction / genetics
  • Skin Neoplasms / diagnosis
  • Skin Neoplasms / genetics*
  • Skin Neoplasms / therapy
  • TOR Serine-Threonine Kinases / antagonists & inhibitors
  • Treatment Outcome
  • ras Proteins / metabolism

Substances

  • NF1 protein, human
  • Neurofibromin 1
  • Protein Kinase Inhibitors
  • MTOR protein, human
  • TOR Serine-Threonine Kinases
  • ras Proteins