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Updated: May 3, 2026
A Protocol for Rapid Post-mortem Cell Culture of Diffuse Intrinsic Pontine Glioma DIPG
Published on: March 7, 2017
Is biopsy safe in children with newly diagnosed diffuse intrinsic pontine glioma?
Stephanie Puget1, Thomas Blauwblomme1, Jacques Grill1
1From the Necker Enfants Malades Hospital, Université Paris Descartes, Sorbonne Paris Cité, France; Gustave Roussy Cancer Institute, Universite Paris Sud, Villejuif, France.
Abstract:
Diffuse intrinsic pontine gliomas (DIPGs), with a median survival of 9 months, represent the biggest therapeutic challenge in pediatric neuro-oncology. Despite many clinical trials, no major improvements in treatment have been made over the past 30 years. In most cases, biopsy is not needed for diagnosis because DIPG diagnosis is based on a typical clinical picture with radiologic evidence on magnetic resonance imaging. Therefore, little data on newly diagnosed DIPG have been published and are confounded by including autopsy (i.e., postradiation therapy) cases. In most cancers, advancing to cure has been linked to the discovery of relevant biomarkers, only found by access to tissue. Therefore, to further understand the biology of DIPG, fresh tissue samples must be obtained at diagnosis. However, most neurosurgical teams are reluctant to perform biopsy in pediatric patients, citing potential risks and lack of direct benefit. Yet, in reviewing 90 patients with and the published data on brainstem biopsy, these procedures have a diagnostic yield and morbidity and mortality rates similar to those reported for other brain locations. In addition, the quality and quantity of the material obtained confirm the diagnosis and inform an extended molecular screen, including biomarker study-information important to designing next-generation trials with targeted agents. Stereotactic biopsies can be considered a safe procedure in well-trained neurosurgical teams and could be incorporated in well-defined protocols for patients with DIPG.
Insights
Biopsying diffuse intrinsic pontine gliomas (DIPG) at diagnosis offers crucial tissue for molecular analysis, potentially improving targeted treatments for this challenging pediatric brain cancer. Despite concerns, stereotactic biopsies are safe and informative.
Area of Science:
- Pediatric neuro-oncology
- Neurosurgery
- Molecular diagnostics
Background:
- Diffuse intrinsic pontine gliomas (DIPG) present a significant therapeutic challenge in pediatric neuro-oncology, with limited treatment advancements over 30 years.
- Diagnosis is typically based on clinical presentation and MRI, leading to a scarcity of data from newly diagnosed DIPG, often confounded by post-treatment autopsy cases.
- Biomarker discovery, essential for advancing cancer cures, requires access to fresh tumor tissue.
Purpose of the Study:
- To evaluate the safety and diagnostic utility of obtaining fresh tissue samples via biopsy at the time of diagnosis for diffuse intrinsic pontine gliomas (DIPG).
- To address the reluctance of neurosurgical teams to perform biopsies in pediatric patients by analyzing risks and benefits.
- To highlight the importance of molecular profiling for developing next-generation targeted therapies for DIPG.
Main Methods:
- Review of 90 patients undergoing brainstem biopsy for DIPG.
- Analysis of diagnostic yield, morbidity, and mortality rates compared to biopsies in other brain locations.
- Assessment of the quality and quantity of tissue obtained for molecular screening.
Main Results:
- Brainstem biopsies for DIPG demonstrated diagnostic yields, morbidity, and mortality rates comparable to those in other brain locations.
- The procedure yields sufficient high-quality tissue for comprehensive molecular screening and biomarker studies.
- Stereotactic biopsy is a safe procedure when performed by experienced neurosurgical teams.
Conclusions:
- Stereotactic biopsy is a safe and valuable procedure for obtaining diagnostic and molecular information from newly diagnosed DIPG patients.
- Incorporating biopsies into defined protocols can provide essential data for designing future clinical trials with targeted agents.
- This approach is critical for advancing the understanding and treatment of DIPG.
