CR-11: PEDIATRIC ADAMANTINOMATOUS CRANIOPHARYNGIOMA CYST FLUID DEMONSTRATES A PRO-INFLAMMATORY MILIEU

BACKGROUND: The cyst component of pediatric adamantinomatous craniopharyngioma (ACP) often exerts substantial mass effect, grows unpredictably, and is poorly responsive to radiation therapy. Current cyst-directed therapies mandate surgical intervention. An improved understanding of the drivers of ACP cyst growth may allow for the identification of systemic therapies that can control cyst expansion and improve tumor control and/or our ability to safely undertake radical tumor resection. METHODS: Milliplex cytokine expression analysis was used to compare the cytokine milieu of ACP cyst (n = 5) to another common cyst generating pediatric brain tumor, Juvenile Pilocytic Astrocytoma (JPA, n = 5). The ratio of cytokine levels in the 2 tumor types was compared. RESULTS: Compared to JPA cysts, all ACP specimens showed a highly pro-inflammatory cytokine pattern. Among the cytokines with elevated expression level ratios in ACP, relative to JPA, were IL-6 (353.9, p = 1.23x10⁻⁵); IL-8 (57.6, p = 0.04); IL-10 (35.5, p = 0.003); TNF-a (8.21, p = 0.01); and IL-1b (3.65, p = 0.005). CONCLUSIONS: ACP cyst fluid appears to be characterized by a highly pro-inflammatory cytokine expression pattern. Understanding the cellular source of these cytokines and the efficacy of selective cytokine blockade may represent an opportunity for therapeutic intervention.