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Published on: November 17, 2021
[The art of war as applied to pediatric gliomas: Know your enemy]
Quentin Bailleul1, Andria Rakotomalala1, Isabelle Ferry1
1Unité tumorigenèse et résistance aux traitements, Centre Oscar Lambret, Place de Verdun, 59045 Lille, France - Univ. Lille, CNRS, Inserm, CHU Lille, Institut de recherche contre le cancer de Lille, UMR9020 - UMR-S 1277 - Canther - Cancer Heterogeneity, Plasticity and Resistance to Therapies, F-59000 Lille, France.
Insights
Pediatric brain cancers, especially Diffuse Intrinsic Pontine Gliomas (DIPG), have poor prognoses. Advances in molecular understanding offer new diagnostic and clinical strategy perspectives for these challenging childhood tumors.
Area of Science:
- Pediatric oncology
- Neuro-oncology
- Molecular biology
Background:
- Pediatric brain cancers are the most common solid tumors in children and a leading cause of cancer-related death.
- Diffuse Intrinsic Pontine Gliomas (DIPG) are particularly aggressive pediatric high-grade gliomas with a dismal prognosis.
- Current treatments like radiotherapy have limited efficacy, and chemotherapy/targeted therapies have largely failed to improve outcomes.
Purpose of the Study:
- To review recent advancements in understanding the molecular alterations in pediatric gliomas.
- To highlight how this new knowledge can lead to more accurate diagnoses.
- To discuss the future clinical strategies informed by molecular insights.
Main Methods:
- Review of high-throughput sequencing data.
- Analysis of molecular alterations in pediatric gliomas.
- Synthesis of current knowledge on pediatric brain tumors.
Main Results:
- High-throughput sequencing has significantly advanced the understanding of molecular changes in pediatric gliomas.
- Distinct biomolecular entities within pediatric gliomas have been identified.
- This progress enables more precise diagnoses and personalized treatment approaches.
Conclusions:
- Molecular profiling is revolutionizing the diagnosis and understanding of pediatric brain cancers.
- New insights into molecular alterations pave the way for improved clinical strategies and potentially better outcomes for children with DIPG and other high-grade gliomas.
Abstract:
Pediatric brain cancers represent the most frequent solid tumors and the leading cause of cancer-driven mortality in children. Pediatric High Grade Gliomas display a very poor prognosis. Among these, DIPG (Diffuse Intrinsic Pontine Gliomas), localized to the brain stem, cannot benefit from a total exeresis due to this critical location and to their highly infiltrating nature. Radiotherapy remains the standard treatment against these tumors for almost five decades, and attempts to improve the prognosis of patients with chemotherapy or targeted therapies have failed. Thanks to the rise of high throughput sequencing, the knowledge of molecular alterations in pediatric gliomas strongly progressed and allowed to highlight distinct biomolecular entities and to establish more accurate diagnoses. In this review, we summarize this new information and the perspectives that it brings for clinical strategies.
