Infantile high-grade glioma with CLIP2-MET fusion mutation: a case report and therapeutic challenges

Glioma infantil de alto grado con mutación de fusión CLIP2-MET: informe de un caso y desafíos terapéuticos

Introduction: Infantile high-grade gliomas are rare malignancies of the central nervous system (CNS) in children. Despite advancements, significant challenges remain in their treatment. A better understanding of their molecular biology may provide new therapeutic options. Clinical case: We report the case of a 30-month-old female diagnosed with an infantile high-grade glioma. Following urgent surgical resection, molecular analysis via a fusion panel identified a CLIP2-MET fusion mutation. This finding suggested potential treatment with crizotinib, a targeted therapy. However, several barriers delayed treatment initiation, including the lack of approval for crizotinib use in CNS tumors in Colombia and concerns about interactions with anticonvulsant therapy. Despite a brief period of clinical stability after initiating treatment, the patient unfortunately succumbed to the disease. Conclusion: Infantile high-grade gliomas pose significant therapeutic challenges, but identifying specific gene fusions, such as CLIP2-MET, may open new avenues for targeted therapy. This case underscores the need for regulatory adaptations to facilitate access to promising treatments when evidence supports their potential efficacy. To our knowledge, this is the first case in Colombia where an infantile glioma was treated with crizotinib, highlighting both the promise and the challenges of precision medicine in pediatric oncology.