Chinese researchers recently revealed new insights on the growth of craniopharyngioma and identified a potential therapeutic treatment.

Their findings were published online in Science Translational Medicine on December 19.

Craniopharyngioma, a benign yet highly invasive tumor occurring along the hypothalamus-pituitary axis, presents a unique clinical challenge. Although nonmalignant, its proximity to critical brain structures often leads to severe endocrine and metabolic complications. The tumor can invade the hypothalamus and pituitary gland, resulting in endocrine dysfunction and metabolic disorders such as obesity, diabetes mellitus, hypothyroidism, diabetes insipidus. In severe cases, it can cause life-threatening conditions. Currently, surgical resection remains the primary treatment option; however, this approach carries high risks, including the risk of recurrence and significant postoperative complications.

To tackle these challenges, a team led by Professor WU Qingfeng from the Institute of Genetics and Developmental Biology of the Chinese Academy of Sciences, in collaboration with the Beijing Institute of Life Sciences, Beijing Tiantan Hospital, and Beijing Children's Hospital, adopted a multi-pronged approach to explore craniopharyngioma growth and also identified a promising treatment option.

In 2021, Professor WU identified the cellular origins of papillary craniopharyngioma. Building on this achievement, he and his team developed two sophisticated animal models that faithfully recapitulate the imageological, histological, phenomic, and transcriptomic characteristics of human craniopharyngioma. These models successfully mimic the pathological progression observed in patients, providing an invaluable platform for studying tumorigenic mechanisms and developing therapeutic interventions.

While bulk, single-cell and spatial transcriptomic analyses revealed an enriched transcriptional program related to synaptic transmission in the mouse tumors, their immunostaining and electron microscopic results further demonstrated synaptic contacts between hypothalamic neurons and tumor cells. Using chemogenetic techniques, the researchers modulated the activity of hypothalamic neuroendocrine neurons in their animal models. They found that enhanced neuronal activity accelerated tumor growth, while reduced activity inhibited it.

These findings highlight the remarkable adaptability of craniopharyngiomas, which hijack hypothalamic neurons and leverage neurotransmitters to enhance their growth and aggressiveness. This work not only deepens our understanding of neuron-to-tumor interactions but also underscores the potential of disrupting neuron-tumor crosstalk as a viable therapeutic strategy.

Using their animal models, the researchers established craniopharyngioma cell lines and screened over 3,000 compounds for their potential antitumor effects. Among the 74 top hits, one stood out: amlodipine besylate, a calcium channel blocker commonly prescribed for hypertension. Surprisingly, this routine medication showed potent antitumor effects in preclinical animal models.

Amlodipine’s established safety profile and widespread use as a cardiovascular drug make it a prime candidate for repurposing. Its efficacy lies in its ability to inhibit calcium signaling pathways in tumor cells. By blocking calcium transients, amlodipine effectively disrupts the chemical synaptic transmission between hypothalamic neurons and tumor cells.

Craniopharyngioma has long been a daunting challenge for neurosurgeons and endocrinologists alike. Understanding this complex tumor’s growth mechanism and identifying a potentially effective, non-invasive medication to treat it mark a significant step forward.

"Our ultimate goal is to provide safer and more effective treatment options for patients," Professor WU said. "This research represents a beacon of hope for improving their quality of life. However, further clinical trials are required to validate the efficacy of amlodipine besylate in patients."