Z Gokce-Samar1, P A Beuriat2, C Faure-Conter1, C Carrie3, S Chabaud4, L Claude3, F Di Rocco5, C Mottolese5, A Szathmari5, C Chabert6, D Frappaz1,7. 1. Department of Pediatric Hematology and Oncology, Institut d'Hématologie et d'Oncologie Pédiatrique, Lyon, France. 2. Department of Pediatric Neurosurgery, Neurological and Neurosurgical Hospital Pierre Wertheimer, Hospice Civils de Lyon, 59 Boulevard Pinel, 69677, Lyon cedex, France. pierre-aurelien.beuriat@neurochirurgie.fr. 3. Department of Radiotherapy, Centre Léon Bérard, Lyon, France. 4. Department of Biostatistics, Centre Léon Bérard, Lyon, France. 5. Department of Pediatric Neurosurgery, Neurological and Neurosurgical Hospital Pierre Wertheimer, Hospice Civils de Lyon, 59 Boulevard Pinel, 69677, Lyon cedex, France. 6. Department of Radiology, Centre Léon Bérard, Lyon, France. 7. Department of Oncology, Centre Léon Bérard, Lyon, France.
Abstract
BACKGROUND: The median survival of patients with diffuse intrinsic pontine glioma (DIPG) remains less than 1 year. The BSG 98 pre-irradiation chemotherapy protocol showed a significant increase in overall survival. In contrast to current treatment strategies, patients did not have to undergo surgical stereotactic biopsy, which can sometimes lead to complications, to be included in this protocol. MATERIALS AND METHODS: We retrospectively reviewed all the cases of DIPG that were treated in our department from September 15, 2004 to September 15, 2014. We compared the group of patients who followed our BSG 98 protocol to those who were treated with new targeted therapy protocols where systematic biopsy was required. RESULTS: Patients in the BSG 98 protocol were treated with BCNU, cisplatin, and methotrexate, followed by radiation at disease progression. Targeted therapy protocols included radiation therapy along with treatment by erlotinib, cilengitide, or an association of nimotuzumab and vinblastine. Sixteen patients were treated with the BSG 98 protocol, and 9 patients were treated with new targeted therapy protocols. Median overall survival was significantly higher in the BSG 98 group compared to the targeted therapy group (16.1 months (95 % CI, 10.4-19.0) vs 8.8 months (95 % CI 1.4-12.3); p = 0.0003). An increase in the median progression-free survival was observed (respectively, 8.6 vs 3.0 months; p = 0.113). CONCLUSION: The present study confirms that the BSG 98 protocol is one of the most effective current treatment strategies for DIPG. It may be used as the control arm in randomized trials investigating the use of innovative treatments and may be proposed to families who are averse to biopsy.
BACKGROUND: The median survival of patients with diffuse intrinsic pontine glioma (DIPG) remains less than 1 year. The BSG 98 pre-irradiation chemotherapy protocol showed a significant increase in overall survival. In contrast to current treatment strategies, patients did not have to undergo surgical stereotactic biopsy, which can sometimes lead to complications, to be included in this protocol. MATERIALS AND METHODS: We retrospectively reviewed all the cases of DIPG that were treated in our department from September 15, 2004 to September 15, 2014. We compared the group of patients who followed our BSG 98 protocol to those who were treated with new targeted therapy protocols where systematic biopsy was required. RESULTS:Patients in the BSG 98 protocol were treated with BCNU, cisplatin, and methotrexate, followed by radiation at disease progression. Targeted therapy protocols included radiation therapy along with treatment by erlotinib, cilengitide, or an association of nimotuzumab and vinblastine. Sixteen patients were treated with the BSG 98 protocol, and 9 patients were treated with new targeted therapy protocols. Median overall survival was significantly higher in the BSG 98 group compared to the targeted therapy group (16.1 months (95 % CI, 10.4-19.0) vs 8.8 months (95 % CI 1.4-12.3); p = 0.0003). An increase in the median progression-free survival was observed (respectively, 8.6 vs 3.0 months; p = 0.113). CONCLUSION: The present study confirms that the BSG 98 protocol is one of the most effective current treatment strategies for DIPG. It may be used as the control arm in randomized trials investigating the use of innovative treatments and may be proposed to families who are averse to biopsy.
Authors: P Therasse; S G Arbuck; E A Eisenhauer; J Wanders; R S Kaplan; L Rubinstein; J Verweij; M Van Glabbeke; A T van Oosterom; M C Christian; S G Gwyther Journal: J Natl Cancer Inst Date: 2000-02-02 Impact factor: 13.506
Authors: Sridharan Gururangan; Susan N Chi; Tina Young Poussaint; Arzu Onar-Thomas; Richard J Gilbertson; Sridhar Vajapeyam; Henry S Friedman; Roger J Packer; Brian N Rood; James M Boyett; Larry E Kun Journal: J Clin Oncol Date: 2010-05-17 Impact factor: 44.544
Authors: Wafik Zaky; Michael Wellner; Robert J Brown; Stefan Blüml; Jonathan L Finlay; Girish Dhall Journal: Pediatr Hematol Oncol Date: 2013-10 Impact factor: 1.969
Authors: Diana S Osorio; Neha Patel; Lingyun Ji; Richard Sposto; Joseph Stanek; Sharon L Gardner; Jeffrey C Allen; Albert Cornelius; Geoffrey B McCowage; Amanda Termuhlen; Ira J Dunkel; Melanie Comito; James Garvin; Jonathan L Finlay Journal: J Neurooncol Date: 2018-11-03 Impact factor: 4.130
Authors: James L Leach; James Roebker; Austin Schafer; Joshua Baugh; Brooklyn Chaney; Christine Fuller; Maryam Fouladi; Adam Lane; Renee Doughman; Rachid Drissi; Mariko DeWire-Schottmiller; David S Ziegler; Jane E Minturn; Jordan R Hansford; Stacie S Wang; Michelle Monje-Deisseroth; Paul G Fisher; Nicholas G Gottardo; Hetal Dholaria; Roger Packer; Katherine Warren; Sarah E S Leary; Stewart Goldman; Ute Bartels; Cynthia Hawkins; Blaise V Jones Journal: Neuro Oncol Date: 2020-11-26 Impact factor: 12.300
Authors: Lindsey M Hoffman; Sophie E M Veldhuijzen van Zanten; Niclas Colditz; Joshua Baugh; Brooklyn Chaney; Marion Hoffmann; Adam Lane; Christine Fuller; Lili Miles; Cynthia Hawkins; Ute Bartels; Eric Bouffet; Stewart Goldman; Sarah Leary; Nicholas K Foreman; Roger Packer; Katherine E Warren; Alberto Broniscer; Mark W Kieran; Jane Minturn; Melanie Comito; Emmett Broxson; Chie-Schin Shih; Soumen Khatua; Murali Chintagumpala; Anne Sophie Carret; Nancy Yanez Escorza; Timothy Hassall; David S Ziegler; Nicholas Gottardo; Hetal Dholaria; Renee Doughman; Martin Benesch; Rachid Drissi; Javad Nazarian; Nada Jabado; Nathalie Boddaert; Pascale Varlet; Géraldine Giraud; David Castel; Stephanie Puget; Chris Jones; Esther Hulleman; Piergiorgio Modena; Marzia Giagnacovo; Manila Antonelli; Torsten Pietsch; Gerrit H Gielen; David T W Jones; Dominik Sturm; Stefan M Pfister; Nicolas U Gerber; Michael A Grotzer; Elke Pfaff; André O von Bueren; Darren Hargrave; Guirish A Solanki; Filip Jadrijevic Cvrlje; Gertjan J L Kaspers; William P Vandertop; Jacques Grill; Simon Bailey; Veronica Biassoni; Maura Massimino; Raphaël Calmon; Esther Sanchez; Brigitte Bison; Monika Warmuth-Metz; James Leach; Blaise Jones; Dannis G van Vuurden; Christof M Kramm; Maryam Fouladi Journal: J Clin Oncol Date: 2018-05-10 Impact factor: 44.544