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

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.