Novel "T-Dimension" Therapies for Pediatric Optic Pathway Glioma: A Timely, Targeted, and Tailored Treatment Trend
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Published on: October 27, 2014
Alice Giotta Lucifero1, Samer K Elbabaa2, Matias Baldoncini3
1Neurosurgery Unit, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy.
Introduction:
Novel targeted and tailored therapies can substantially improve the prognosis for optic pathway glioma (OPG), especially when implemented in a timely manner. However, their tremendous potential remains underestimated. Therefore, in this study, we provide an updated overview of the clinical trials, current trends, and future perspectives for OPG's novel therapeutic strategies.
Methods:
We completed an extensive literature review using the PubMed, MEDLINE, and ClinicalTrials.gov databases. We analyzed and reported the data following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
Results:
Thioguanine, procarbazine, lomustine, and vincristine/vinblastine, as well as cisplatin-etoposide, provided excellent results in advanced-phase trials. Selumetinib and trametinib, two oral MEK inhibitors, have been approved for recurrent or refractory OPGs in association with the angiogenetic inhibitor bevacizumab. Among the mTOR inhibitors, everolimus and sirolimus showed the best results. Stereotactic radiosurgery and proton beam radiation therapy have advantages over conventional radiotherapy regimens. Timely treatment is imperative for acute visual symptoms with evidence of tumor progression. This latest evidence can help define a novel "T-Dimension" for pediatric OPG therapies.
Conclusion:
The novel "T-Dimension" for pediatric OPGs is based on recent evidence-based treatments, including combination chemotherapy regimens, molecular targeted therapies, stereotactic radiosurgery, and proton beam radiation therapy. Additional clinical trials are essential for validating each of these new therapies.
Insights
Novel therapies like targeted chemotherapy and advanced radiation offer improved outcomes for optic pathway glioma (OPG). A new "T-Dimension" approach emphasizes timely, evidence-based treatments for better pediatric OPG prognosis.
Area of Science:
- Ophthalmology and Oncology
- Pediatric Neuro-oncology
Background:
- Optic pathway glioma (OPG) prognosis can be significantly improved with timely, novel targeted therapies, yet their full potential is often underestimated.
- This study provides an updated overview of emerging therapeutic strategies for OPG, focusing on clinical trials and current trends.
Approach:
- An extensive literature review was conducted using PubMed, MEDLINE, and ClinicalTrials.gov.
- Data analysis and reporting adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
Key Points:
- Combination chemotherapy regimens (thioguanine, procarbazine, lomustine, vincristine/vinblastine, cisplatin-etoposide) show promise in advanced trials.
- Approved MEK inhibitors (selumetinib, trametinib) combined with bevacizumab are effective for recurrent/refractory OPG.
- mTOR inhibitors (everolimus, sirolimus) and advanced radiation techniques (stereotactic radiosurgery, proton beam therapy) demonstrate significant advantages.
- Timely intervention is crucial for acute visual symptoms and tumor progression, defining a new 'T-Dimension' for pediatric OPG treatment.
Conclusions:
- The novel 'T-Dimension' for pediatric OPG integrates evidence-based treatments including combination chemotherapy, molecular targeted therapies, and advanced radiation techniques.
- Further clinical trials are necessary to validate the efficacy of these emerging OPG therapies.
