Clinical and radiological response of Maffucci related enchondromas to mutant IDH1 inhibitor Ivosidenib

Bone. 2024 Nov:188:117221. doi: 10.1016/j.bone.2024.117221. Epub 2024 Aug 2.

Abstract

Ollier Disease (OD) and Maffucci syndrome (MS) is a rare bone disorder that affects the growth and development of the bones, with an estimated prevalence of 1 in 100,000 people. It is associated with somatic mosaicism of isocitrate dehydrogenase-1 (IDH1) or 2 (IDH2) pathogenic variants. Ivosidenib is indicated for the treatment of acute myeloid leukemia and locally advanced or metastatic cholangiocarcinoma and is currently investigated in low-grade glioma with a susceptible isocitrate dehydrogenase-1 (IDH1) pathogenic variant, but its effects in patients with OD or MS are unknown. We here report the first case of a patient with MS who was treated with Ivosidenib for recurrent IDH-1 mutated glioma. Besides the stabilization of the tumor size, the patient observed significant improvement in his enchondromas that became stiffer, with reduced pain, and significant modification of the mineralization of the enchondromas observed on X-rays. This first case report provides hope for the medical management of patients suffering because of OD or MS. Future clinical research is urgently needed to evaluate long-term benefit risk profile of IDH inhibitors in these rare diseases.

Keywords: Enchondromas; Endochondral ossification; Glioma; IDH inhibitor therapy; Maffucci syndrome; Ollier disease; X-rays.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Chondroma / diagnostic imaging
  • Chondroma / drug therapy
  • Chondroma / pathology
  • Enchondromatosis* / diagnostic imaging
  • Enchondromatosis* / drug therapy
  • Enchondromatosis* / genetics
  • Enchondromatosis* / pathology
  • Glycine* / analogs & derivatives
  • Glycine* / therapeutic use
  • Humans
  • Isocitrate Dehydrogenase* / antagonists & inhibitors
  • Isocitrate Dehydrogenase* / genetics
  • Male
  • Mutation* / genetics
  • Pyridines* / therapeutic use
  • Radiography

Substances

  • Isocitrate Dehydrogenase
  • ivosidenib
  • IDH1 protein, human
  • Pyridines
  • Glycine