On of the meetings with potential is the 26th Annual American Society of Pediatric Hematology and Oncology (ASPHO) Anual Meeting being held in Miami from April 24-27. With all the different pediatric blood and cancer disorders, I don't usually expect much success in looking for brain tumor abstracts let alone DIPG. This year, though, I was surprised by abstract 750 (page S67):
Is Biopsy Safe in Diffuse Intrinsic Pontine Glioma?
An Institutional Experience
The surprise didn't end there. Although the institutions is one of the collaborators for the multi-institutional trial with molecular determination for treatment by upfront biopsy, it is not one that has been obviously on the forefront of the US biopsy debate- Children's Hospital of Michigan in Detroit.
These authors report on 22 newly diagnosed children with DIPG between 2002 and 2012. Stealth guided biopsies were performed in 68% of the cases. There were no deaths related to biopsy. Three of the fifteen children undergoing biopsy has transient issues post-operative which resolved within two weeks. The issues included one child developed a facial nerve palsy, one child has some speech difficulty and extremity weakness and the third has ataxia and swallowing difficulties.
All biopsies showed gliomas (grade 2-4).
The authors conclude that biopsy at their institution has been relatively safe and the resulting tissue will allow for molecular profiling which may lead to targeted therapy and perhaps in the future prolonged survival or a cure.
So, why is the percentage of biopsy so high at this institution? These authors report a case of theirs in which a child was found to have a PNET tumor rather than a glioma. Subsequently, biopsy is considered in the majority of these tumors at diagnosis.
Molecularly Determined Treatment of Diffuse Intrinsic Pontine Glioma