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A Protocol for Rapid Post-mortem Cell Culture of Diffuse Intrinsic Pontine Glioma DIPG
Published on: March 7, 2017
Emerging Therapeutic Strategies for Diffuse Intrinsic Pontine Glioma: A Systematic Review
Shahrukh Farrukh1, Shagufta Habib2, Amna Rafaqat3
1Department of Research, Khawaja Muhammad Safdar Medical College, Sialkot 51310, Pakistan.
Background:
Of all central nervous systems tumors, 10-20% are located in the brainstem; diffuse intrinsic pontine glioma (DIPG) is diagnosed in 80% of them. With over five decades of clinical trial testing, there are no established therapeutic options for DIPG. This research article aims to collate recent clinical trial data and provide a landscape for the most promising therapies that have emerged in the past five years.
Methods:
PubMed/MEDLINE, Web of Science, Scopus, and Cochrane were systematically searched using the following keywords: Diffuse intrinsic pontine glioma, Pontine, Glioma, Treatment, Therapy, Therapeutics, curative, and/or Management. Both adult and pediatric patients with newly diagnosed or progressive DIPG were considered in the clinical trial setting. The risk of bias was assessed using the ROBINS-I tool.
Results:
A total of 22 trials were included reporting the efficacy and safety outcomes among patients. First, five trials reported outcomes of blood-brain barrier bypass via single or repeated-dose intra-arterial therapy or convection-enhanced delivery. Second, external beam radiation regimens were assessed for safety and efficacy in three trials. Third, four trials administered intravenous treatment without using chemotherapeutic regimens. Fourth, eight trials reported the combinations of one or more chemotherapeutic agents. Fifth, immunotherapy was reported in two trials in an adjuvant monotherapy in the post-radiotherapy setting.
Conclusion:
This research article captures a clinical picture of the last five years of the direction toward which DIPG research is heading. The article finds that re-irradiation may prolong survival in patients with progressive DIPG; it also instills that insofar palliative radiotherapy has been a key prognostic choice.
Insights
Diffuse intrinsic pontine glioma (DIPG) lacks effective treatments. Recent clinical trials show re-irradiation may improve survival for progressive DIPG, with palliative radiotherapy remaining crucial.
Area of Science:
- Neuro-oncology
- Pediatric Oncology
- Clinical Trials
Background:
- Diffuse intrinsic pontine glioma (DIPG) accounts for 80% of brainstem tumors.
- Despite decades of research, no established therapies exist for DIPG.
- This review analyzes recent clinical trial data to identify promising DIPG treatments.
Purpose of the Study:
- To collate and analyze recent clinical trial data for Diffuse Intrinsic Pontine Glioma (DIPG).
- To provide an overview of emerging and promising therapeutic strategies for DIPG over the past five years.
Main Methods:
- Systematic literature search of PubMed/MEDLINE, Web of Science, Scopus, and Cochrane.
- Keywords included 'Diffuse intrinsic pontine glioma,' 'Pontine Glioma,' 'Treatment,' and 'Therapeutics.'
- Included adult and pediatric patients; risk of bias assessed using ROBINS-I.
Main Results:
- Twenty-two trials reported efficacy and safety outcomes.
- Investigated therapies included blood-brain barrier bypass, external beam radiation, intravenous treatments, chemotherapy combinations, and immunotherapy.
- Immunotherapy was explored as adjuvant monotherapy post-radiotherapy.
Conclusions:
- Re-irradiation shows potential to prolong survival in progressive DIPG patients.
- Palliative radiotherapy remains a significant prognostic factor in DIPG management.
- The study highlights current research trends in DIPG therapeutics.
