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Targeted Radionuclide Therapy in Diffuse Intrinsic Brainstem Gliomas: Exploring Options Beyond the Finish Line.

Yamini Dharmashaktu1, Madhavi Tripathi1, Sanjana Ballal1

  • 1Departments of Nuclear Medicine.

Clinical Nuclear Medicine
|June 10, 2025
PubMed
Summary
This summary is machine-generated.

This study explores radiotheranostics for diffuse intrinsic brainstem gliomas (DIPG), a rare pediatric brain tumor. Targeted therapies show promise in managing residual disease after conventional treatment.

Keywords:
DIPGPRRTpediatric tumors

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Area of Science:

  • Oncology
  • Nuclear Medicine
  • Pediatric Neuro-oncology

Background:

  • Diffuse intrinsic brainstem gliomas (DIPG) are aggressive pediatric brain tumors, predominantly occurring in the pons.
  • DIPG has a poor prognosis, with limited treatment options and high-grade, infiltrative characteristics.

Purpose of the Study:

  • To investigate the potential of radiotheranostics in treating a pediatric patient with diffuse intrinsic brainstem glioma (DIPG) exhibiting residual disease.
  • To evaluate the efficacy and safety of targeted radionuclide therapy in a challenging pediatric neuro-oncology case.

Main Methods:

  • A 12-year-old girl with DIPG received standard radiotherapy and temozolomide, followed by gallium-68 (68Ga) prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) scan.
  • The patient subsequently underwent targeted radionuclide therapy with lutetium-177 (Lu-177) PSMA-617 and actinium-225 (Ac-225) PSMA-617.

Main Results:

  • 68Ga PSMA PET/CT demonstrated significant tracer accumulation in the pontine tumor mass, indicating PSMA expression.
  • The patient received multiple cycles of Lu-177 PSMA-617 and Ac-225 PSMA-617 therapy, with outcomes to be detailed.

Conclusions:

  • Radiotheranostics targeting PSMA show potential as a novel therapeutic strategy for pediatric DIPG with residual disease.
  • This case highlights the feasibility of using PSMA-targeted radioligand therapy in pediatric neuro-oncology, warranting further investigation.