Trametinib for multiple non-ossifying fibromas due to KRAS mosaic mutations: two case reports
Abstract
Introduction The best first-line mechanical thrombectomy treatment for acute ischemic stroke (AIS) caused by anterior large vessel occlusion (LVO) remains unclear despite four randomised controlled trials (RCTs). We compared the effectiveness and safety of the first-line combined stent retriever (SR) + contact aspiration (CA) approach with SR or CA alone for the treatment of AIS due to LVO. Patients and Methods This retrospective analysis combines individual patient data from 3 large multicenter, RCTs: ASTER, ASTER2, and VECTOR. The primary outcome was the proportion of patients who achieved favourable recanalisation (defined as a modified Thrombolysis in Cerebral Infarction score of 2b, 2c or 3) after the first-line treatment, without a second-line rescue technique. Secondary outcomes included the first pass effect, disability assessed by the 90-day modified Rankin Scale (mRS) score, 24-hour change in National Institutes of Health Stroke Scale (NIHSS), 90-day all-cause mortality, and serious procedure-related adverse events. Results Among 1,185 included patients, 434 received the combined approach, 414 received CA alone, and 337 received SR alone. Baseline characteristics were similar among groups. After adjusting for factors using propensity score weighting, the primary outcome was achieved more often in the combined group compared to CA alone (risk ratio = 1.95; 95% CI, 1.42 to 2.68; P < 0.001) or SR alone (Odds ratio = 1.70; 95% CI, 1.21 to 2.38; P = .002). There were no significant differences in 24-hour change in NIHSS, 90-day mRS, or adverse events among the groups. Conclusions In this pooled analysis of 3 RCTs, the combined approach as the first-line treatment for anterior circulation LVO increased the probability of achieving favourable recanalisation without the need for a second-line approach, compared to CA or SR alone but no impact on clinical outcomes was detected.
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BibTeX
@article{vincent2026trametinib,
title = {{Trametinib for multiple non-ossifying fibromas due to KRAS mosaic mutations: two case reports}},
author = {Marie Vincent and Soizic Tiriau and Marine Fouillet-Desjonqueres and Alicia Besson and Wassim Ouchetto and Sébastien Barbarot and Bertrand Isidor and Aymeric Rouchaud and Geneviève Baujat and Pierre Vabres and Patrick Edery and Marion Delous and Massimiliano Rossi},
journal = {Communications Medicine},
year = {2026},
month = may,
doi = {10.1038/s43856-026-01615-5},
url = {https://hal.science/hal-05751625v1},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Trametinib for multiple non-ossifying fibromas due to KRAS mosaic mutations: two case reports
AU - Marie Vincent
AU - Soizic Tiriau
AU - Marine Fouillet-Desjonqueres
AU - Alicia Besson
AU - Wassim Ouchetto
AU - Sébastien Barbarot
AU - Bertrand Isidor
AU - Aymeric Rouchaud
AU - Geneviève Baujat
AU - Pierre Vabres
AU - Patrick Edery
AU - Marion Delous
AU - Massimiliano Rossi
PY - 2026
DA - 2026/05/18
JO - Communications Medicine
DO - 10.1038/s43856-026-01615-5
UR - https://hal.science/hal-05751625v1
AB - Introduction The best first-line mechanical thrombectomy treatment for acute ischemic stroke (AIS) caused by anterior large vessel occlusion (LVO) remains unclear despite four randomised controlled trials (RCTs). We compared the effectiveness and safety of the first-line combined stent retriever (SR) + contact aspiration (CA) approach with SR or CA alone for the treatment of AIS due to LVO. Patients and Methods This retrospective analysis combines individual patient data from 3 large multicenter, RCTs: ASTER, ASTER2, and VECTOR. The primary outcome was the proportion of patients who achieved favourable recanalisation (defined as a modified Thrombolysis in Cerebral Infarction score of 2b, 2c or 3) after the first-line treatment, without a second-line rescue technique. Secondary outcomes included the first pass effect, disability assessed by the 90-day modified Rankin Scale (mRS) score, 24-hour change in National Institutes of Health Stroke Scale (NIHSS), 90-day all-cause mortality, and serious procedure-related adverse events. Results Among 1,185 included patients, 434 received the combined approach, 414 received CA alone, and 337 received SR alone. Baseline characteristics were similar among groups. After adjusting for factors using propensity score weighting, the primary outcome was achieved more often in the combined group compared to CA alone (risk ratio = 1.95; 95% CI, 1.42 to 2.68; P < 0.001) or SR alone (Odds ratio = 1.70; 95% CI, 1.21 to 2.38; P = .002). There were no significant differences in 24-hour change in NIHSS, 90-day mRS, or adverse events among the groups. Conclusions In this pooled analysis of 3 RCTs, the combined approach as the first-line treatment for anterior circulation LVO increased the probability of achieving favourable recanalisation without the need for a second-line approach, compared to CA or SR alone but no impact on clinical outcomes was detected.
SN - 2730-664X
ER -