Neurofibromatosis

disease
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Also known as neurofibromatosis syndrome

Summary

Neurofibromatosis (MONDO:0021061) is a disease (an umbrella term covering 5 Mondo subtypes) with 2 cohort genes and 23 clinical trials. Top therapeutic interventions include cabozantinib, nilotinib, and pirfenidone.

At a glance

  • Umbrella term: 5 Mondo subtypes
  • Cohort genes: 2
  • ClinVar variants: 3
  • Clinical trials: 23

Clinical features

No curated clinical features (Orphanet) for this disease.

Identifiers

Disease identifiers

FieldValue
Canonical nameneurofibromatosis
Mondo IDMONDO:0021061
EFOEFO:0008514
MeSHD017253
DOIDDOID:8712
ICD-10-CMQ85.0
NCITC6727
SNOMED CT19133005
UMLSC0162678
MedGen58149
GARD0010420
Is cancer (heuristic)no

Also known as: neurofibromatosis · neurofibromatosis syndrome

Data availability: 3 ClinVar variants · 1 GenCC gene-disease record.

Disease family

An umbrella term covering 5 Mondo subtypes.

Classification path: disease › human disease › disease by etiologic mechanism › disease of genetic or genomic mechanism › hereditary disease › autosomal genetic disease › autosomal dominant disease › neurofibromatosis

Related subtypes (191): autosomal dominant polycystic liver disease, cerebral arteriopathy, autosomal dominant, with subcortical infarcts and leukoencephalopathy, type 1, tuberous sclerosis, Treacher-Collins syndrome, hereditary breast ovarian cancer syndrome, autosomal dominant polycystic kidney disease, Lynch syndrome, branchio-oto-renal syndrome, autosomal dominant Aarskog syndrome, acroosteolysis dominant type, ADULT syndrome, autosomal dominant Alport syndrome, amelogenesis imperfecta type 1B, Townes-Brocks syndrome, nevoid basal cell carcinoma syndrome, blepharophimosis, ptosis, and epicanthus inversus syndrome, autosomal dominant brachyolmia, branchiooculofacial syndrome, pheochromocytoma/paraganglioma syndrome 4, cataract-aberrant oral frenula-growth delay syndrome, cherubism, autosomal dominant chondrodysplasia punctata, autosomal dominant popliteal pterygium syndrome, blepharocheilodontic syndrome, cochleosaccular degeneration-cataract syndrome, renal coloboma syndrome, Beare-Stevenson cutis gyrata syndrome, autosomal dominant vibratory urticaria, neurohypophyseal diabetes insipidus, autosomal dominant Kenny-Caffey syndrome, Rapp-Hodgkin syndrome, Ehlers-Danlos syndrome, classic type, autosomal dominant Ehlers-Danlos syndrome, vascular type, multiple endocrine neoplasia type 1, Coffin-Siris syndrome 1, isolated congenital adermatoglyphia, Flynn-Aird syndrome, Frasier syndrome, hand-foot-genital syndrome, Holt-Oram syndrome, hyperkeratosis-hyperpigmentation syndrome, autosomal dominant ichthyosis vulgaris, hyper-IgE recurrent infection syndrome 1, autosomal dominant, autosomal dominant keratitis, autosomal dominant keratitis-ichthyosis-hearing loss syndrome, LADD syndrome, trichorhinophalangeal syndrome type II, Noonan syndrome with multiple lentigines, microcephaly with or without chorioretinopathy, lymphedema, or intellectual disability, Marfan syndrome, melanoma, cutaneous malignant, susceptibility to, 2, autosomal dominant primary microcephaly, autosomal dominant progressive external ophthalmoplegia, monilethrix, Muir-Torre syndrome, autosomal dominant myoglobinuria, autosomal dominant centronuclear myopathy, nail-patella syndrome, multiple endocrine neoplasia type 2B, autosomal dominant omodysplasia, pheochromocytoma/paraganglioma syndrome 1, Pelger-Huet anomaly, multiple endocrine neoplasia type 2A, piebaldism, autosomal dominant medullary cystic kidney disease with or without hyperuricemia, generalized juvenile polyposis/juvenile polyposis coli, juvenile polyposis/hereditary hemorrhagic telangiectasia syndrome, Peutz-Jeghers syndrome, contractures, pterygia, and spondylocarpotarsal fusion syndrome 1A, autosomal dominant distal renal tubular acidosis, retinoschisis, autosomal dominant, autosomal dominant Robinow syndrome, scapuloperoneal spinal muscular atrophy, autosomal dominant, autosomal dominant sideroblastic anemia, spondyloepiphyseal dysplasia tarda, autosomal dominant, proximal symphalangism, calcaneonavicular coalition, thanatophoric dysplasia type 1, trichorhinophalangeal syndrome type I, Muckle-Wells syndrome, autosomal dominant hypophosphatemic rickets, von Hippel-Lindau disease, Denys-Drash syndrome, autosomal dominant severe congenital neutropenia, Costello syndrome, EEC syndrome, multiple cutaneous and mucosal venous malformations, diffuse nonepidermolytic palmoplantar keratoderma, Timothy syndrome, pheochromocytoma/paraganglioma syndrome 2, spondyloepimetaphyseal dysplasia with multiple dislocations, Brooke-Spiegler syndrome, macrocephaly-autism syndrome, pheochromocytoma/paraganglioma syndrome 3, Duane-radial ray syndrome, PCWH syndrome, heart-hand syndrome, Slovenian type, congenital stationary night blindness autosomal dominant 3, mandibulofacial dysostosis-microcephaly syndrome, multiple endocrine neoplasia type 4, juvenile cataract-microcornea-renal glucosuria syndrome, Crouzon syndrome-acanthosis nigricans syndrome, Birk-Barel syndrome, thrombophilia due to protein S deficiency, autosomal dominant, dyskeratosis congenita, autosomal dominant 2, dyskeratosis congenita, autosomal dominant 3, colorectal cancer, hereditary nonpolyposis, type 6, colorectal cancer, hereditary nonpolyposis, type 7, brain small vessel disease 2A, autosomal dominant, intellectual disability, autosomal dominant 14, intellectual disability, autosomal dominant 15, intellectual disability, autosomal dominant 16, hypopigmentation-punctate palmoplantar keratoderma syndrome, intellectual disability-facial dysmorphism syndrome due to SETD5 haploinsufficiency, postaxial polydactyly-anterior pituitary anomalies-facial dysmorphism syndrome, intellectual developmental disorder with microcephaly and with or without ocular malformations or hypogonadotropic hypogonadism, intellectual disability, autosomal dominant 29, intellectual disability, autosomal dominant 30, Houge-Janssens syndrome 2, severe achondroplasia-developmental delay-acanthosis nigricans syndrome, dyskeratosis congenita, autosomal dominant 6, epidermolysis bullosa simplex 6, generalized, with scarring and hair loss, autosomal dominant complex spastic paraplegia, early-onset autosomal dominant Alzheimer disease, muscular dystrophy, limb-girdle, autosomal dominant, Feingold syndrome, Carney complex, neuronopathy, distal hereditary motor, autosomal dominant, autosomal dominant coarctation of aorta, autosomal dominant spondylocostal dysostosis, autosomal dominant hypohidrotic ectodermal dysplasia, Cowden disease, autosomal dominant distal myopathy, autosomal dominant rhegmatogenous retinal detachment, palmoplantar keratoderma-spastic paralysis syndrome, Alagille syndrome due to a JAG1 point mutation, PTEN hamartoma tumor syndrome, gastric adenocarcinoma and proximal polyposis of the stomach, autosomal dominant proximal renal tubular acidosis, autosomal dominant spastic ataxia, Waardenburg syndrome, hereditary retinoblastoma, autosomal dominant hypocalcemia, Li-Fraumeni syndrome, Loeys-Dietz syndrome, hereditary hemorrhagic telangiectasia, hereditary inclusion body myopathy-joint contractures-ophthalmoplegia syndrome, microcephalic osteodysplastic dysplasia, Saul-Wilson type, autosomal dominant intermediate Charcot-Marie-Tooth disease, autosomal dominant cutis laxa, autosomal dominant nonsyndromic hearing loss, autosomal dominant optic atrophy, autosomal dominant Emery-Dreifuss muscular dystrophy, autosomal dominant cerebellar ataxia, autosomal dominant osteopetrosis, autosomal dominant epidermolytic ichthyosis, ventricular arrhythmias due to cardiac ryanodine receptor calcium release deficiency syndrome, distal arthrogryposis type 2B1, autosomal dominant cataract, arthrogryposis, distal, type 2B2, arthrogryposis, distal, type 2B3, Charcot-Marie-Tooth disease, demyelinating, type 1G, Delpire-McNeill syndrome, LAMA5-related multisystemic syndrome, autosomal dominant oculocutaneous albinism, Charcot-Marie-tooth disease, axonal, type 2DD, Pilarowski-Bjornsson syndrome, intellectual disability, autosomal dominant, fatty acyl-CoA reductase 1 upregulation, GUCY2D-related dominant retinopathy, RPE65-related dominant retinopathy, autosomal dominant titinopathy, NOG-related symphalangism spectrum disorder, ALPL-related autosomal dominant hypophosphatasia, MYH10-related neurodevelopmental disorder with congenital anomalies, spastic paraplegia 30A, autosomal dominant, TMEM127-related tumor predisposition, MAX-related tumor predisposition, BMPR1A-related juvenile polyposis syndrome, RP1-related dominant retinopathy, Birt-Hogg-Dube syndrome, inclusion body myopathy and brain white matter abnormalities, KINSSHIP syndrome, autosomal dominant nebulin-related myopathy, IMPG1-related dominant retinopathy, PROM1-related dominant retinopathy, PURA-related severe neonatal hypotonia-seizures-encephalopathy syndrome, ALG8-related autosomal dominant polycystic kidney and/or liver disease, NOTCH1-related AOS spectrum disorder, FLNB-associated autosomal dominant filamin related bone disorder, familial antiphospholipid syndrome

Subtypes (5): NF2-related schwannomatosis, schwannomatosis, neurofibromatosis, type IV, of Riccardi, neurofibromatosis-Noonan syndrome, neurofibromatosis type 1

Genetics & variants

GWAS landscape

No GWAS associations recorded — common-variant (GWAS) studies don’t cover this disease (typical for Mendelian / rare diseases). See the curated gene cohort and Mendelian overlap below.

Variant details and genetic-evidence tiers

ClinVar germline variants

3 retrieved; paginated sample, class counts are floors:

2 pathogenic, 1 likely pathogenic

ClinVarVariant (HGVS)GeneClassificationReview
2775421NM_001042492.3(NF1):c.6188T>A (p.Leu2063Ter)NF1Pathogeniccriteria provided, single submitter
3336802NM_001042492.3(NF1):c.2427_2428dup (p.Lys810fs)NF1Pathogeniccriteria provided, single submitter
3769588NM_001042492.3(NF1):c.5477_5478insG (p.His1826fs)NF1Likely pathogeniccriteria provided, single submitter

Genes & proteins

Mendelian disease overlap and somatic drivers

GenCC: 1 · Orphanet: 9 · OMIM-shared: 0 · Dual-evidence (GWAS+Mendelian): 0

GenCC gene–disease validity (cohort genes)

the Disease column is the GenCC-asserted condition — a cohort gene’s strongest validity may be for a related predisposition syndrome.

GeneClassificationInheritanceDiseaseRecords
CABIN1LimitedAutosomal dominantneurofibromatosis

Orphanet rare-disease linkage (cohort genes)

GeneOrphanet IDRare disease
NF1Orphanet:13947417q11.2 microduplication syndrome
NF1Orphanet:29072Hereditary pheochromocytoma-paraganglioma
NF1Orphanet:293199Pleomorphic rhabdomyosarcoma
NF1Orphanet:363700Neurofibromatosis type 1 due to NF1 mutation or intragenic deletion
NF1Orphanet:638Neurofibromatosis-Noonan syndrome
NF1Orphanet:86834Juvenile myelomonocytic leukemia
NF1Orphanet:9768517q11 microdeletion syndrome
NF1Orphanet:99756Alveolar rhabdomyosarcoma
NF1Orphanet:99757Embryonal rhabdomyosarcoma

Cohort genes → proteins

2 cohort genes, 2 distinct canonical proteins.

Evidence partition

SubsetGenes
multi_evidence2

Cohort genes (full)

SymbolHGNCEnsemblUniProtNameEvidence
CABIN1HGNC:24187ENSG00000099991Q9Y6J0Calcineurin-binding protein cabin-1gencc
NF1HGNC:7765ENSG00000196712P21359Neurofibrominclinvar

Cohort function summary

Lead sentence per gene, UniProt-curated.

SymbolProtein nameFunction (lead sentence)
CABIN1Calcineurin-binding protein cabin-1May be required for replication-independent chromatin assembly.
NF1NeurofibrominStimulates the GTPase activity of Ras.

Protein-family classification

Druggable: 0 · Difficult: 0 · Unknown: 2 · Druggable fraction: 0.0

Family distribution

Cohort families vs a genome-wide background (hypergeometric, BH-FDR; fold = observed/expected). Counts kept; sorted by enrichment, so the catch-all Other/Unknown bucket no longer leads.

FamilyGenesFoldFDR
Other/Unknown21.8×0.312

Per-gene assignment

SymbolFamilyDruggable?ECInterPro (top 3)
CABIN1Other/UnknownnoTPR-like_helical_dom_sf, MEF2-bd, TPR_rpt
NF1Other/UnknownnoCRAL-TRIO_dom, RasGAP_dom, Rho_GTPase_activation_prot

Expression context

Cohort genes with no expression data: 0.

2 cohort genes are a single-cell marker in ≥1 SCXA experiment.

Breadth distribution (Bgee present_calls)

BucketGenes
narrow (1-5 tissues)0
moderate (6-20)0
broad (>20)2
unknown0

Top tissues across cohort

TissueCohort genes
cerebellar cortex1
cerebellar hemisphere1
right hemisphere of cerebellum1
adrenal tissue1
calcaneal tendon1
colonic epithelium1

Per-gene tissue summary (top 30)

SymbolBgee breadthFANTOM5 breadthSCXATop tissues
CABIN1294ubiquitousmarkerright hemisphere of cerebellum, cerebellar hemisphere, cerebellar cortex
NF1283ubiquitousmarkercolonic epithelium, calcaneal tendon, adrenal tissue

Protein interactions among cohort

Intra-cohort edges: 0.

Hub genes (top 10 by interactor count)

SymbolInteractor count
NF15,540
CABIN11,630

Structural data

PDB: 2 · AlphaFold-only: 0 · No structure: 0

Cohort genes with PDB structures (top 30)

SymbolUniProtPDB entries
NF1P2135926
CABIN1Q9Y6J01

Function

Pathway analysis

Distinct Reactome pathways touched by cohort: 14. Enrichment computed across 2 evidence-associated genes (2 with Reactome annotation).

Pathways by enrichment

Over-representation of cohort genes vs the genome-wide background (hypergeometric test, Benjamini-Hochberg FDR; fold = observed/expected over 2 annotated cohort genes). Counts and members are kept as ground-truth; sorted by enrichment.

PathwayCohort genesFoldFDRSample cohort genes
RAS signaling downstream of NF1 loss-of-function variants1815.7×0.017NF1
Formation of Senescence-Associated Heterochromatin Foci (SAHF)1335.9×0.021CABIN1
Oncogenic MAPK signaling1124.1×0.030NF1
Regulation of RAS by GAPs196.8×0.030NF1
DNA Damage/Telomere Stress Induced Senescence181.6×0.030CABIN1
Cellular Senescence168.8×0.030CABIN1
MAPK1/MAPK3 signaling165.6×0.030NF1
MAPK family signaling cascades151.4×0.034NF1
RAF/MAP kinase cascade130.5×0.049NF1
Diseases of signal transduction by growth factor receptors and second messengers128.4×0.049NF1
Cellular responses to stress118.4×0.068CABIN1
Cellular responses to stimuli115.7×0.073CABIN1
Disease16.5×0.158NF1
Signal Transduction15.1×0.187NF1

GO biological processes by enrichment

Over-representation of cohort genes vs the genome-wide background (hypergeometric test, Benjamini-Hochberg FDR; fold = observed/expected over 2 annotated cohort genes). Counts and members are kept as ground-truth; sorted by enrichment.

GO termCohort genesFoldFDRSample cohort genes
positive regulation of mast cell apoptotic process18426.0×0.003NF1
regulation of glial cell differentiation18426.0×0.003NF1
observational learning18426.0×0.003NF1
gamma-aminobutyric acid secretion, neurotransmission14213.0×0.003NF1
Schwann cell proliferation12808.7×0.003NF1
forebrain astrocyte development12808.7×0.003NF1
Schwann cell migration12808.7×0.003NF1
glutamate secretion, neurotransmission12808.7×0.003NF1
negative regulation of mast cell proliferation12808.7×0.003NF1
negative regulation of Schwann cell migration12808.7×0.003NF1
vascular associated smooth muscle cell migration12808.7×0.003NF1
mast cell apoptotic process12106.5×0.003NF1
negative regulation of Rac protein signal transduction12106.5×0.003NF1
myeloid leukocyte migration12106.5×0.003NF1
mast cell proliferation11685.2×0.004NF1
amygdala development11404.3×0.004NF1
regulation of blood vessel endothelial cell migration11404.3×0.004NF1
vascular associated smooth muscle cell proliferation11404.3×0.004NF1
negative regulation of Schwann cell proliferation11203.7×0.004NF1
negative regulation of neurotransmitter secretion11203.7×0.004NF1
hair follicle maturation11053.2×0.004NF1
negative regulation of leukocyte migration1842.6×0.005NF1
negative regulation of vascular associated smooth muscle cell migration1842.6×0.005NF1
regulation of bone resorption1766.0×0.005NF1
negative regulation of astrocyte differentiation1766.0×0.005NF1
regulation of long-term synaptic potentiation1766.0×0.005NF1
positive regulation of extrinsic apoptotic signaling pathway in absence of ligand1766.0×0.005NF1
forebrain morphogenesis1702.2×0.005NF1
regulation of cell-matrix adhesion1648.1×0.005NF1
negative regulation of neuroblast proliferation1601.9×0.005NF1

Therapeutics

Drugs indicated for this disease

0 approved, 1 in late-stage (phase 3) trials. Disease-direct ChEMBL indications, not inferred from the associated-gene cohort below.

DrugDevelopment status
SirolimusPhase 3 (in late-stage trials)

Drug target analysis

Approved (phase 4): 0 · Phase ≥3: 0 · Phased (≥1): 0 · Undrugged: 2

Druggability breadth: 0 of 2 evidence-associated genes (0%) have a ChEMBL target (buckets above are over the deeply-mined display cohort).

Top cohort targets by molecule count

SymbolMoleculesMax phase
CABIN100
NF100

Bioactivity and enzyme data

Enzyme cohort genes (≥1 EC): 0.

Pharmacogenomics

Cohort genes with a PharmGKB record: 2; with CPIC/DPWG dosing guidelines: 0.

No cohort gene has a CPIC/DPWG genotype-guided dosing guideline (PharmGKB).

Chemical tractability of cohort targets

0 approved/phased compounds have measured bioactivity against a cohort gene (and aren’t yet in disease-level trials). This is a research / tractability signal, NOT a therapeutic recommendation — a bioactivity row often reflects off-target or screening binding (e.g. promiscuous kinase inhibitors against a cohort kinase), implying no disease mechanism.

Druggability pyramid

Cohort genes binned by druggability tier (high → low):

TierDefinitionGenesSymbols
AApproved (phase 4 drug)0
BPhased (≥1) drug, not yet approved0
CDruggable family + PDB, no drug0
DDruggable family + AlphaFold only, no drug0
EDifficult family or no structure, no drug2CABIN1, NF1

Undrugged target profiles

2 cohort genes are undrugged. Ranked by ‘starting-point quality’ (assay depth + drugged-partner adjacency).

SymbolChEMBL assaysDrugged partners (top 3)
CABIN10
NF10

Clinical trials & evidence

Clinical trials

Clinical trials: 23.

Phase distribution (across all retrieved trials)

PhaseTrials
Not specified9
PHASE26
PHASE14
EARLY_PHASE12
PHASE31
PHASE1/PHASE21

Top trials by phase / activity

NCTPhaseStatusTitle
NCT04461886PHASE3TERMINATEDA Long-term Study of NPC-12G Gel in Neurofibromatosis Type I
NCT00589784PHASE2COMPLETEDPhase II Trial of Sunitinib (SU011248) in Patients With Recurrent or Inoperable Meningioma
NCT00754780PHASE2COMPLETEDClinical Trial of Pirfenidone in Adult Patients With Neurofibromatosis 1
NCT01140360PHASE1/PHASE2COMPLETEDPilot Study of Gleevec/Imatinib Mesylate (STI-571, NSC 716051) in Neurofibromatosis (NF1) Patient With Plexiform Neurofibromas
NCT01402817PHASE2TERMINATEDStudy of Sutent®/Sunitinib (SU11248) in Subjects With NF-1 Plexiform Neurofibromas
NCT01673009PHASE2COMPLETEDPhase II Study of Gleevec/Imatinib Mesylate (STI-571, NCS 716051) in Neurofibromatosis (NF1) Patients With Plexiform Neurofibromas
NCT02096471PHASE2COMPLETEDMEK Inhibitor PD-0325901 Trial in Adolescents and Adults With NF1
NCT02101736PHASE2COMPLETEDCabozantinib for Plexiform Neurofibromas (PN) in Subjects With NF1 in Children and Adults
NCT06961565PHASE1RECRUITINGPAS-004 in Adults Who Have Neurofibromatosis Type 1 With Plexiform Neurofibromas
NCT07102394PHASE1RECRUITINGFeasibility and Tolerability of IMLYGIC for the Treatment of Cutaneous Neurofibromas in Adults With NF1
NCT02211768PHASE1COMPLETEDTransformation of Plexiform Neurofibromas to Malignant Peripheral Nerve Sheath Tumors in Neurofibromatosis Type 1
NCT03649165PHASE1COMPLETEDA Study to Evaluate Bioavailability and Food Effect of Selumetinib (AZD6244) in Healthy Male Participants
NCT01275586EARLY_PHASE1COMPLETEDStudy of Tasigna®/Nilotinib (AMN107) in Neurofibromatosis (NF1) Patients With Plexiform Neurofibromas
NCT01633008EARLY_PHASE1COMPLETEDAcceptance and Commitment Therapy for Adolescents and Young Adults With Neurofibromatosis and Chronic Pain
NCT00598351Not specifiedRECRUITINGNatural History Study of Patients With Neurofibromatosis Type 2
NCT04463316Not specifiedRECRUITINGGROWing Up With Rare GENEtic Syndromes
NCT05028166Not specifiedAVAILABLEIndividual Patient Compassionate Use of Mirdametinib
NCT05581511Not specifiedACTIVE_NOT_RECRUITINGNatural History Study of Cutaneous Neurofibromas in People With NF1
NCT07088991Not specifiedRECRUITINGClinical and Demographic Characteristics of Adult p Atients With NEurofibromatosis in RUSsia
NCT00508235Not specifiedCOMPLETEDQuality of Friendships in Children With Neurofibromatosis
NCT01639950Not specifiedCOMPLETEDValidating Pain Scales in Children and Young Adults
NCT02298270Not specifiedCOMPLETEDResiliency Training for Patients With Neurofibromatosis Via Videoconferencing With Skype
NCT02435628Not specifiedCOMPLETEDRelationship Between Psychosocial Factors, Health Literacy, Quality of Life and Satisfaction With Medical Visits in Adults With NF

Drugs tested across these trials (top 30)

MoleculeMax phaseTrials referencing
CABOZANTINIB41
NILOTINIB41
PIRFENIDONE41
SUNITINIB41
TALIMOGENE LAHERPAREPVEC41
MIRDAMETINIB21
CHEMBL27511702
CHEMBL451771401
CHEMBL540543601
CHEMBL421550101
CHEMBL484972101
EXELIXIS01