DIPG/DIPT Discussion

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A searchable blog on DIPG research, DIPG news, recent publications, DIPG Foundations, DIPG researchers, clinical trials as well as other issues relating to Diffuse Intrinsic Pontine Tumors- both Diffuse Intrinsic Pontine Gliomas (DIPGs) and Atypical Pontine Lesions (APLs).

For parents, family and friends of children with DIPG looking for information and connection to others dealing with DIPG please check the buttons on the right hand side for resources.

Wednesday, March 20, 2013

Biopsy Consensus Statements on DIPGs

Over the last few years there have been rapid change in treating and understanding pediatric brain tumors.   Per this recently electronically published article in Neuro Oncology these include :
1) Brainstem tumors are now considered to be safe targets for either stereotactic or open biopsy;
2) Age is a major factor interacting with tumor behavior (progression risk);
3) Recent research identifying new biologic markers of tumor classification and new druggable targets for trials has provided and opportunity to explore novel approaches to therapy.

In  February 2011, the second Consensus Conference on Pediatric Neurosurgery (CPN 2011) was held in Paris, France with the objective to establish a new consensus on surgical approaches to pediatric gliomas.   Statements on high grade gliomas, hypothalamic chiasmatic gliomas and diffuse intrinsic pontine gliomas were developed.  Statements  were disseminated to the 92 participants for a vote.  A statement was accepted if there was more than 70% of votes in favor of the statement.

Here are the final statements regarding DIPGs.
Typical DIPG
Biopsy of  a typical DIPG (defined by a short history and typical imaging findings) is justified when the patient is part of an ethically approved clinical study in which the tissue obtained will be used to investigate or inform the role of biological markers after treatment selection or molecular tumor grading.

Atypical Pontine Region Tumors
(A) Biopsy by an experienced pediatric neurosurgeon is indicated to confirm the diagnosis and guide therapy,
(B) An atypical pontine region tumor would be considered separately from classic DIPG for therapy or research purposes.

Authors of the final consensus paper included:
* David A Walker- Nottingham, United Kingdom
* JoFen Liu- Boston, USA
* Mark Kieran- Boston,  USA
* Nada Jabado- Quebec, Canada
* Susan Picton- Leeds, United Kingdom
* Roger Packer- Washington, USA
* Christian St. Rose - Paris, France

A multi-disciplinary consensus statement concerning surgical approaches to low grade, high grade astrocytomas and diffuse intrinsic pontine gliomas (CPN Paris 2011) using the Delphi method.
Neuro Oncol 2013 March 15 [epub ahead of print]