Doxycycline Injection of Cutaneous Schwannoma in Neurofibromatosis Type 2
In this research study the investigators want to learn more about an alternate, local treatment for skin schwannomas. Specifically, local doxycycline intra-tumoral injection will be performed as a potential treatment for NF2-related skin schwannomas, ultimately reducing the risks and costs associated with standard surgical removal of such skin tumors if successful.
• Patients must have a confirmed diagnosis of neurofibromatosis 2 by fulfilling National Institute of Health (NIH) criteria or Manchester criteria, or by detection of a causative mutation in the NF2 gene.
• The NIH criteria include presence of:
⁃ Bilateral vestibular schwannomas, OR
⁃ First-degree relative with NF2 and EITHER unilateral eighth nerve mass OR
⁃ Two of the following: neurofibroma, meningioma, glioma, schwannoma, juvenile posterior subcapsular lenticular opacity.
• The Manchester criteria include presence of:
⁃ Bilateral vestibular schwannomas, OR First-degree relative with NF2 and EITHER unilateral eighth nerve mass OR - Two of the following: neurofibroma, meningioma, glioma, schwannoma, juvenile posterior subcapsular lenticular opacity OR
⁃ Unilateral vestibular schwannoma AND any two of: neurofibroma, meningioma, glioma, schwannoma, juvenile posterior subcapsular lenticular opacity, OR
⁃ Multiple meningiomas (two or more) AND unilateral vestibular schwannoma OR
⁃ Any two of: schwannoma, glioma, neurofibroma, cataract.
• Patients must have measurable disease, defined as at least one cutaneous/subcutaneous schwannoma with the following qualities:
‣ Maximal tumor diameter \> 0.5 cm to \< 4.0 cm that can be accurately measured by electronic calipers
⁃ Up to a maximum of 3 tumors/subject may be injected
⁃ Not located on the face
• Age ≥ 8 years on day 1 of treatment.
• Life expectancy of greater than 1 year
• Lansky/Karnofsky performance status ≥ 60
• Fully recovered from acute toxic effects of any prior chemotherapy, biological modifiers or radiotherapy
• Any neurologic deficits must be stable for ≥1 week
• Patient or parent/legal guardian must be able to provide signed informed consent and assent (as applicable for minors)