Diagnostics and treatment of diffuse intrinsic pontine glioma: where do we stand?

Fatma E. El-Khouly, Sophie E.M. Veldhuijzen van Zanten, Vicente Santa-Maria Lopez, N. Harry Hendrikse, Gertjan J.L. Kaspers, G. Loizos, David Sumerauer, Karsten Nysom, Kaie Pruunsild, Virve Pentikainen, Halldora K. Thorarinsdottir, Giedre Rutkauskiene, Victor Calvagna, Monika Drogosiewicz, Monica Dragomir, Ladislav Deak, Lidija Kitanovski, Andre O. von Bueren, Rejin Kebudi, Irene SlavcSandra Jacobs, Filip Jadrijevic-Cvrlje, Natacha Entz-Werle, Jacques Grill, Antonis Kattamis, Peter Hauser, Jane Pears, Veronica Biassoni, Maura Massimino, Enrique Lopez Aguilar, Ingrid K. Torsvik, Maria Joao Gil-da-Costa, Ella Kumirova, Ofelia Cruz-Martinez, Stefan Holm, Simon Bailey, Tim Hayden, Ulrich W. Thomale, Geert O.R. Janssens, Christof M. Kramm, Dannis G. van Vuurden

Research output: Contribution to journalArticle

Abstract

Introduction: Diffuse intrinsic pontine glioma (DIPG) is a rare clinically, neuro-radiologically, and molecularly defined malignancy of the brainstem with a median overall survival of approximately 11 months. Our aim is to evaluate the current tendency for its treatment in Europe in order to develop (inter)national consensus guidelines. Methods: Healthcare professionals specialized in DIPG were asked to fill in an online survey with questions regarding usual treatment strategies at diagnosis and at disease progression in their countries and/or their centers, respectively. Results: Seventy-four healthcare professionals responded to the survey, of which 87.8% were pediatric oncologists. Only 13.5% of the respondents biopsy all of their patients, 41.9% biopsy their patients infrequently. More than half of the respondents (54.1%) treated their patients with radiotherapy only at diagnosis, whereas 44.6% preferred radiotherapy combined with chemotherapy. When the disease progresses, treatment strategies became even more diverse, and the tendency for no treatment increased from 1.4% at diagnosis to 77.0% after second progression. 36.5% of the healthcare professionals treat children younger than 3 years differently than older children at diagnosis. This percentage decreased, when the disease progresses. Most of the participants (51.4%) included less than 25% of their patients in clinical trials. Conclusion: This survey demonstrates a large heterogeneity of treatment regimens, especially at disease progression. We emphasize the need for international consensus guidelines for the treatment of DIPG, possible by more collaborative clinical trials.

Original languageEnglish
Pages (from-to)177-184
Number of pages8
JournalJournal of Neuro-Oncology
Volume145
Issue number1
DOIs
Publication statusPublished - Oct 1 2019

Fingerprint

Glioma
Delivery of Health Care
Disease Progression
Radiotherapy
Therapeutics
Clinical Trials
Guidelines
Biopsy
Brain Stem
Surveys and Questionnaires
Pediatrics
Drug Therapy
Survival
Neoplasms

Keywords

  • Chemotherapy
  • Diffuse intrinsic pontine glioma (DIPG)
  • Diffuse midline glioma H3-K27 mutant (DMG K3-27M)
  • Radiotherapy

ASJC Scopus subject areas

  • Oncology
  • Neurology
  • Clinical Neurology
  • Cancer Research

Cite this

El-Khouly, F. E., Veldhuijzen van Zanten, S. E. M., Santa-Maria Lopez, V., Hendrikse, N. H., Kaspers, G. J. L., Loizos, G., ... van Vuurden, D. G. (2019). Diagnostics and treatment of diffuse intrinsic pontine glioma: where do we stand? Journal of Neuro-Oncology, 145(1), 177-184. https://doi.org/10.1007/s11060-019-03287-9

Diagnostics and treatment of diffuse intrinsic pontine glioma : where do we stand? / El-Khouly, Fatma E.; Veldhuijzen van Zanten, Sophie E.M.; Santa-Maria Lopez, Vicente; Hendrikse, N. Harry; Kaspers, Gertjan J.L.; Loizos, G.; Sumerauer, David; Nysom, Karsten; Pruunsild, Kaie; Pentikainen, Virve; Thorarinsdottir, Halldora K.; Rutkauskiene, Giedre; Calvagna, Victor; Drogosiewicz, Monika; Dragomir, Monica; Deak, Ladislav; Kitanovski, Lidija; von Bueren, Andre O.; Kebudi, Rejin; Slavc, Irene; Jacobs, Sandra; Jadrijevic-Cvrlje, Filip; Entz-Werle, Natacha; Grill, Jacques; Kattamis, Antonis; Hauser, Peter; Pears, Jane; Biassoni, Veronica; Massimino, Maura; Lopez Aguilar, Enrique; Torsvik, Ingrid K.; Joao Gil-da-Costa, Maria; Kumirova, Ella; Cruz-Martinez, Ofelia; Holm, Stefan; Bailey, Simon; Hayden, Tim; Thomale, Ulrich W.; Janssens, Geert O.R.; Kramm, Christof M.; van Vuurden, Dannis G.

In: Journal of Neuro-Oncology, Vol. 145, No. 1, 01.10.2019, p. 177-184.

Research output: Contribution to journalArticle

El-Khouly, FE, Veldhuijzen van Zanten, SEM, Santa-Maria Lopez, V, Hendrikse, NH, Kaspers, GJL, Loizos, G, Sumerauer, D, Nysom, K, Pruunsild, K, Pentikainen, V, Thorarinsdottir, HK, Rutkauskiene, G, Calvagna, V, Drogosiewicz, M, Dragomir, M, Deak, L, Kitanovski, L, von Bueren, AO, Kebudi, R, Slavc, I, Jacobs, S, Jadrijevic-Cvrlje, F, Entz-Werle, N, Grill, J, Kattamis, A, Hauser, P, Pears, J, Biassoni, V, Massimino, M, Lopez Aguilar, E, Torsvik, IK, Joao Gil-da-Costa, M, Kumirova, E, Cruz-Martinez, O, Holm, S, Bailey, S, Hayden, T, Thomale, UW, Janssens, GOR, Kramm, CM & van Vuurden, DG 2019, 'Diagnostics and treatment of diffuse intrinsic pontine glioma: where do we stand?', Journal of Neuro-Oncology, vol. 145, no. 1, pp. 177-184. https://doi.org/10.1007/s11060-019-03287-9
El-Khouly FE, Veldhuijzen van Zanten SEM, Santa-Maria Lopez V, Hendrikse NH, Kaspers GJL, Loizos G et al. Diagnostics and treatment of diffuse intrinsic pontine glioma: where do we stand? Journal of Neuro-Oncology. 2019 Oct 1;145(1):177-184. https://doi.org/10.1007/s11060-019-03287-9
El-Khouly, Fatma E. ; Veldhuijzen van Zanten, Sophie E.M. ; Santa-Maria Lopez, Vicente ; Hendrikse, N. Harry ; Kaspers, Gertjan J.L. ; Loizos, G. ; Sumerauer, David ; Nysom, Karsten ; Pruunsild, Kaie ; Pentikainen, Virve ; Thorarinsdottir, Halldora K. ; Rutkauskiene, Giedre ; Calvagna, Victor ; Drogosiewicz, Monika ; Dragomir, Monica ; Deak, Ladislav ; Kitanovski, Lidija ; von Bueren, Andre O. ; Kebudi, Rejin ; Slavc, Irene ; Jacobs, Sandra ; Jadrijevic-Cvrlje, Filip ; Entz-Werle, Natacha ; Grill, Jacques ; Kattamis, Antonis ; Hauser, Peter ; Pears, Jane ; Biassoni, Veronica ; Massimino, Maura ; Lopez Aguilar, Enrique ; Torsvik, Ingrid K. ; Joao Gil-da-Costa, Maria ; Kumirova, Ella ; Cruz-Martinez, Ofelia ; Holm, Stefan ; Bailey, Simon ; Hayden, Tim ; Thomale, Ulrich W. ; Janssens, Geert O.R. ; Kramm, Christof M. ; van Vuurden, Dannis G. / Diagnostics and treatment of diffuse intrinsic pontine glioma : where do we stand?. In: Journal of Neuro-Oncology. 2019 ; Vol. 145, No. 1. pp. 177-184.
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abstract = "Introduction: Diffuse intrinsic pontine glioma (DIPG) is a rare clinically, neuro-radiologically, and molecularly defined malignancy of the brainstem with a median overall survival of approximately 11 months. Our aim is to evaluate the current tendency for its treatment in Europe in order to develop (inter)national consensus guidelines. Methods: Healthcare professionals specialized in DIPG were asked to fill in an online survey with questions regarding usual treatment strategies at diagnosis and at disease progression in their countries and/or their centers, respectively. Results: Seventy-four healthcare professionals responded to the survey, of which 87.8{\%} were pediatric oncologists. Only 13.5{\%} of the respondents biopsy all of their patients, 41.9{\%} biopsy their patients infrequently. More than half of the respondents (54.1{\%}) treated their patients with radiotherapy only at diagnosis, whereas 44.6{\%} preferred radiotherapy combined with chemotherapy. When the disease progresses, treatment strategies became even more diverse, and the tendency for no treatment increased from 1.4{\%} at diagnosis to 77.0{\%} after second progression. 36.5{\%} of the healthcare professionals treat children younger than 3 years differently than older children at diagnosis. This percentage decreased, when the disease progresses. Most of the participants (51.4{\%}) included less than 25{\%} of their patients in clinical trials. Conclusion: This survey demonstrates a large heterogeneity of treatment regimens, especially at disease progression. We emphasize the need for international consensus guidelines for the treatment of DIPG, possible by more collaborative clinical trials.",
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TY - JOUR

T1 - Diagnostics and treatment of diffuse intrinsic pontine glioma

T2 - where do we stand?

AU - El-Khouly, Fatma E.

AU - Veldhuijzen van Zanten, Sophie E.M.

AU - Santa-Maria Lopez, Vicente

AU - Hendrikse, N. Harry

AU - Kaspers, Gertjan J.L.

AU - Loizos, G.

AU - Sumerauer, David

AU - Nysom, Karsten

AU - Pruunsild, Kaie

AU - Pentikainen, Virve

AU - Thorarinsdottir, Halldora K.

AU - Rutkauskiene, Giedre

AU - Calvagna, Victor

AU - Drogosiewicz, Monika

AU - Dragomir, Monica

AU - Deak, Ladislav

AU - Kitanovski, Lidija

AU - von Bueren, Andre O.

AU - Kebudi, Rejin

AU - Slavc, Irene

AU - Jacobs, Sandra

AU - Jadrijevic-Cvrlje, Filip

AU - Entz-Werle, Natacha

AU - Grill, Jacques

AU - Kattamis, Antonis

AU - Hauser, Peter

AU - Pears, Jane

AU - Biassoni, Veronica

AU - Massimino, Maura

AU - Lopez Aguilar, Enrique

AU - Torsvik, Ingrid K.

AU - Joao Gil-da-Costa, Maria

AU - Kumirova, Ella

AU - Cruz-Martinez, Ofelia

AU - Holm, Stefan

AU - Bailey, Simon

AU - Hayden, Tim

AU - Thomale, Ulrich W.

AU - Janssens, Geert O.R.

AU - Kramm, Christof M.

AU - van Vuurden, Dannis G.

PY - 2019/10/1

Y1 - 2019/10/1

N2 - Introduction: Diffuse intrinsic pontine glioma (DIPG) is a rare clinically, neuro-radiologically, and molecularly defined malignancy of the brainstem with a median overall survival of approximately 11 months. Our aim is to evaluate the current tendency for its treatment in Europe in order to develop (inter)national consensus guidelines. Methods: Healthcare professionals specialized in DIPG were asked to fill in an online survey with questions regarding usual treatment strategies at diagnosis and at disease progression in their countries and/or their centers, respectively. Results: Seventy-four healthcare professionals responded to the survey, of which 87.8% were pediatric oncologists. Only 13.5% of the respondents biopsy all of their patients, 41.9% biopsy their patients infrequently. More than half of the respondents (54.1%) treated their patients with radiotherapy only at diagnosis, whereas 44.6% preferred radiotherapy combined with chemotherapy. When the disease progresses, treatment strategies became even more diverse, and the tendency for no treatment increased from 1.4% at diagnosis to 77.0% after second progression. 36.5% of the healthcare professionals treat children younger than 3 years differently than older children at diagnosis. This percentage decreased, when the disease progresses. Most of the participants (51.4%) included less than 25% of their patients in clinical trials. Conclusion: This survey demonstrates a large heterogeneity of treatment regimens, especially at disease progression. We emphasize the need for international consensus guidelines for the treatment of DIPG, possible by more collaborative clinical trials.

AB - Introduction: Diffuse intrinsic pontine glioma (DIPG) is a rare clinically, neuro-radiologically, and molecularly defined malignancy of the brainstem with a median overall survival of approximately 11 months. Our aim is to evaluate the current tendency for its treatment in Europe in order to develop (inter)national consensus guidelines. Methods: Healthcare professionals specialized in DIPG were asked to fill in an online survey with questions regarding usual treatment strategies at diagnosis and at disease progression in their countries and/or their centers, respectively. Results: Seventy-four healthcare professionals responded to the survey, of which 87.8% were pediatric oncologists. Only 13.5% of the respondents biopsy all of their patients, 41.9% biopsy their patients infrequently. More than half of the respondents (54.1%) treated their patients with radiotherapy only at diagnosis, whereas 44.6% preferred radiotherapy combined with chemotherapy. When the disease progresses, treatment strategies became even more diverse, and the tendency for no treatment increased from 1.4% at diagnosis to 77.0% after second progression. 36.5% of the healthcare professionals treat children younger than 3 years differently than older children at diagnosis. This percentage decreased, when the disease progresses. Most of the participants (51.4%) included less than 25% of their patients in clinical trials. Conclusion: This survey demonstrates a large heterogeneity of treatment regimens, especially at disease progression. We emphasize the need for international consensus guidelines for the treatment of DIPG, possible by more collaborative clinical trials.

KW - Chemotherapy

KW - Diffuse intrinsic pontine glioma (DIPG)

KW - Diffuse midline glioma H3-K27 mutant (DMG K3-27M)

KW - Radiotherapy

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