So far it has been difficult to predicatively monitor DIPG tumor. MRI’s have not been found to be predictive. Other advanced imaging techniques are and have bee studied. The issue of biomarkers has also been approached. Unfortunately with DIPG, tissue analysis is something that is rarely done because of the infrequency of biopsies with this tumor. However there has been some investigation of urinary and blood biomarkers.
The recent publication from the NIH regarding a pegylated inteferon for DIPG had a small subsection on the evaluation of urinary VEGF (vascular endothelial growth factor) and serum bFGF (basic fibroblast growth factor) and MMP-9(matrix metalloproteinases). Interestingly what was found in the small number of patient that had low urine VEGF, low serum bFGF) and a non-rising level of MMP-9 were more likely to survive longer than 2 years. On the other hand, none of those with high urine VEGF, high serum bFGF and a rising level of MMP-9 were long-term survivors.
This is not a new concept for cancer or brain tumors. In fact in 2008 Boston Children’s reported on a panel of urinary biomarkers that predicted presence and response to therapy. The issue that is evolving is the study of serum and urine biomarkers for DIPG.
Conventional MRI cannot predict survival in childhood diffuse intrinsic pontine glioma
J Neurooncol. Feb;86(3):313-9. Epub 2007 Oct 2.
http://www.ncbi.nlm.nih.gov/pubmed/17909941
A phase 2 study of pegylated interferon α-2b (PEG-Intron®) in children with diffuse intrinsic pontine glioma. Cancer. 2011 Nov 15. doi: 10.1002/cncr.26659. [Epub ahead of print]
http://www.ncbi.nlm.nih.gov/pubmed/22086404
Urinary biomarkers predict brain tumor presence and response to therapy.
Clin Cancer Res. 2008 Apr 15;14(8):2378-86.
http://www.ncbi.nlm.nih.gov/pubmed/18413828
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