Pharmacologic Management of Obesity in Neuro-Oncology: A Case Report

Case Rep Oncol. 2024 Dec 17;18(1):169-173. doi: 10.1159/000543178. eCollection 2025 Jan-Dec.

Abstract

Introduction: Brain tumors are the most common solid tumors in pediatric oncology. Advances in the treatment of childhood brain tumors have led to increased survival; however, treatment-related morbidity remains high. The risk of developing overweight/obesity or significant weight gain is commonly observed in children with a brain tumor often due to hypothalamic damage as a result of radiation therapy, surgery, or the tumor itself. This may be accompanied by endocrinopathies such as diabetes insipidus and central precocious puberty in survivors of a childhood brain tumor. Lifestyle intervention strategies are often ineffective in preventing and managing obesity. Patients have difficulty with adherence to dietary interventions due to prolonged exposure to high-dose steroids, compromised physical health due to the disease process, or limitations in mobility as a result of excessive weight gain or the sequelae of the tumor management. There are no effective interventions to prevent or manage obesity in this patient population.

Case presentation: We describe a case report of a 11-year-old female who underwent treatment for a ganglioglioma, WHO grade 1, and simultaneously experienced nearly 100-kg weight gain. After several unsuccessful attempts at lifestyle interventions, she was referred to endocrinology and prescribed a GLP-1 receptor agonist, semaglutide. Following treatment with semaglutide, significant weight loss was observed. Importantly, the patient reported enhanced quality of life and social activity.

Conclusion: Anti-obesity medications are promising treatment options for this vulnerable patient group. Additional research is warranted to examine their use for the prevention and treatment of obesity in children with a brain tumor.

Keywords: Brain tumor; Neuro-oncology; Nutrition; Obesity; Pediatric.

Publication types

  • Case Reports

Grants and funding

Elena J. Ladas was supported by the funding agency Columbia University Irving Medical Center. The funding agency supports the salaries of the PI for preparation for the manuscript. No involvement in preparation of data or manuscript was provided. No funding was provided for Alexandra Lardieri, Vidhu Thaker, Kate Citron-Zafrin, James H. Garvin, and Stergios Zacharoulis.