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Gazzin A, Leoni C, Viscogliosi G, Borgini F, Perri L, Iacoviello M, Piglionica M, De Pellegrin M, Ferrero GB, Bartuli A, Zampino G, Buonuomo PS, Resta N, Mussa A. Work-Up and Treatment Strategies for Individuals with PIK3CA-Related Disorders: A Consensus of Experts from the Scientific Committee of the Italian Macrodactyly and PROS Association. Genes (Basel) 2023; 14:2134. [PMID: 38136956 PMCID: PMC10742781 DOI: 10.3390/genes14122134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 11/23/2023] [Accepted: 11/25/2023] [Indexed: 12/24/2023] Open
Abstract
PIK3CA-related disorders encompass many rare and ultra-rare conditions caused by somatic genetic variants that hyperactivate the PI3K-AKT-mTOR signaling pathway, which is essential for cell cycle control. PIK3CA-related disorders include PIK3CA-related overgrowth spectrum (PROS), PIK3CA-related vascular malformations and PIK3CA-related non-vascular lesions. Phenotypes are extremely heterogeneous and overlapping. Therefore, diagnosis and management frequently involve various health specialists. Given the rarity of these disorders and the limited number of centers offering optimal care, the Scientific Committee of the Italian Macrodactyly and PROS Association has proposed a revision of the most recent recommendations for the diagnosis, molecular testing, clinical management, follow-up, and treatment strategies. These recommendations give insight on molecular diagnosis, eligible samples, preferable sequencing, and validation methods and management of negative results. The purpose of this paper is to promote collaboration between health care centers and clinicians with a joint shared approach. Finally, we suggest the direction of present and future research studies, including new systemic target therapies, which are currently under evaluation in several clinical trials, such as specific inhibitors that can be employed to downregulate the signaling pathway.
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Affiliation(s)
- Andrea Gazzin
- Clinical Pediatric Genetics Unit, Department of Public Health and Pediatrics, University of Torino, Regina Margherita Children’s Hospital, 10126 Torino, Italy; (A.G.); (A.M.)
- Postgraduate School of Pediatrics, University of Torino, 10126 Torino, Italy
| | - Chiara Leoni
- Center for Rare Diseases and Birth Defects, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy; (G.V.); (L.P.); (G.Z.)
| | - Germana Viscogliosi
- Center for Rare Diseases and Birth Defects, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy; (G.V.); (L.P.); (G.Z.)
| | - Federica Borgini
- Italian Macrodactyly and PROS Association, 27010 San Genesio ed Uniti (PV), Italy;
| | - Lucrezia Perri
- Center for Rare Diseases and Birth Defects, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy; (G.V.); (L.P.); (G.Z.)
| | - Matteo Iacoviello
- Medical Genetics Unit, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari “Aldo Moro”, 70124 Bari, Italy; (M.I.); (M.P.); (N.R.)
| | - Marilidia Piglionica
- Medical Genetics Unit, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari “Aldo Moro”, 70124 Bari, Italy; (M.I.); (M.P.); (N.R.)
| | - Maurizio De Pellegrin
- Pediatric Orthopedic Unit, Piccole Figlie Hospital, 43125 Parma, Italy
- Department of Orthopedics, ASST Ospedale Papa Giovanni XXIII, 24127 Bergamo, Italy
| | | | - Andrea Bartuli
- Rare Disease and Medical Genetics Unit, Bambino Gesù Children’s Hospital, IRCCS, 00168 Rome, Italy; (A.B.); (P.S.B.)
| | - Giuseppe Zampino
- Center for Rare Diseases and Birth Defects, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy; (G.V.); (L.P.); (G.Z.)
- Faculty of Medicine and Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Paola Sabrina Buonuomo
- Rare Disease and Medical Genetics Unit, Bambino Gesù Children’s Hospital, IRCCS, 00168 Rome, Italy; (A.B.); (P.S.B.)
| | - Nicoletta Resta
- Medical Genetics Unit, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari “Aldo Moro”, 70124 Bari, Italy; (M.I.); (M.P.); (N.R.)
| | - Alessandro Mussa
- Clinical Pediatric Genetics Unit, Department of Public Health and Pediatrics, University of Torino, Regina Margherita Children’s Hospital, 10126 Torino, Italy; (A.G.); (A.M.)
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