Several research studies have been conducted to seek more information on brain stem glioma in children. Conformal radiotherapy is used as improved radiation therapy for giving high doses of radiation therapy directly to the tumor cells. Research studies focus on evaluating the abnormal molecular features of brain stem glioma cells to diagnose better and categorize these tumors. Imaging techniques are being developed to help the surgeon pinpoint the tumor’s exact position to lessen or prevent damage to the healthy parts of the brain. Different types of targeted therapy are being studied in the treatment of brain stem gliomas involving Dabrafenib (BRAF kinase inhibitor) and trametinib (MEK kinase inhibitor) for treating newly diagnosed focal glioma and recurrent brain stem glioma, Panobinostat for treating DIPG that did not respond to treatment or recurring, monoclonal antibodies treating pediatric brain tumors that are growing, spreading, or getting worse (progressive) or in newly diagnosed DIPG. New methods called convection-enhanced delivery for giving chemotherapy are also being studied.
Immunotherapy research has looked at drugs known as immune checkpoint inhibitors to manage advanced cancer. Tissue donations can help researchers learn more about how tumors change and spread to develop new treatments for brain stem glioma children. Palliative care is integrated among the patients for improving their comfort and quality of life.
Advancement in Brain Stem Glioma – Childhood Research
Based on Latest Research on Brain stem Glioma – Childhood, The areas of research may include new options for patients through clinical trials:
Improved Radiation therapy
Conformal radiotherapy is a method to give high doses of radiation therapy directly to the tumor and not to healthy cells. This technique creates 3-dimensional maps of the brain and the tumor letting the doctors know exactly where to deliver the radiation therapy. Also, drugs designed to enhance the effectiveness of radiation therapy or to slow or stop tumor growth are being studied 1.
Research focuses on evaluating the abnormal molecular features of brain stem glioma cells to diagnose better and categorize these tumors. These features are found by examining the tumor after a biopsy and may help doctors find treatments that target the tumor based on the specific molecular features.
Improved imaging and surgery
Imaging techniques are being developed that help the surgeon pinpoint the tumor’s exact position to lessen or prevent damage to the healthy parts of the brain. For instance, image-guided stereotaxis allows surgeons to visualize and operate on the brain using 3-dimensional computerized outlines of the brain and the tumor. Along with specialized software, these images help direct the surgeon to the tumor. Tumors that were considered inoperable can now be removed with the help of this technique. In some instances, these imaging techniques are also being used to understand better the advantages and risks of using a biopsy to diagnose children with diffuse brain stem glioma.
Targeted therapy aims at any factor contributing to cancer cells growth and development. It can be a specific protein, gene or tissue environment. Researchers are inspecting new treatments targeting certain molecular features found in the tumor for Brain stem glioma.
Based on Latest Research on Brain stem Glioma there are Different types of targeted therapy are being studied in the treatment of brain stem gliomas:
Dabrafenib (BRAF kinase inhibitor) and trametinib (MEK kinase inhibitor)
Dabrafenib (BRAF kinase inhibitor) and trametinib (MEK kinase inhibitor) are being studied to treat newly diagnosed focal glioma and recurrent brain stem glioma 2.
Panobinostat is being studied for the treatment of DIPG that did not respond to treatment or recurring 3.
A monoclonal antibody
APX005M, binds to CD40, a cell surface receptor present on specific immune cells and a few cancer cells. It fights cancer by enhancing the immune system and by slowing cancer cell growth. It is being studied in treating pediatric brain tumors that are growing, spreading, or getting worse (progressive) or in newly diagnosed DIPG 4.
New ways of chemotherapy
The blood-brain barrier that protects the brain and spinal cord from damaging chemicals keep out different types of chemotherapy. New methods called convection-enhanced delivery for giving chemotherapy are being studied. This technique uses a narrow tube called a catheter placed into the brain so chemotherapy can be directed at the tumor.
Immunotherapies boost the natural defence of the body against cancer. Immunotherapy research has been looking at drugs known as immune checkpoint inhibitors to manage advanced cancer. For brain stem glioma, doctors have been researching vaccines that can help treat the tumor.
Some families find that donating tissue feels appropriate as part of the grieving process after their child’s death. Like organ donation, tissue donations can help researchers learn more about how tumors change and spread to develop new treatments for children having brain stem glioma 5.
Clinical trials find a better way to reduce current therapies’ symptoms and side effects to improve patient’s comfort and quality of life.
- 1.Zaghloul MS, Eldebawy E, Ahmed S, et al. Hypofractionated conformal radiotherapy for pediatric diffuse intrinsic pontine glioma (DIPG): A randomized controlled trial. Radiotherapy and Oncology. Published online April 2014:35-40. doi:10.1016/j.radonc.2014.01.013
- 2.Perreault S, Larouche V, Tabori U, et al. A phase 2 study of trametinib for patients with pediatric glioma or plexiform neurofibroma with refractory tumor and activation of the MAPK/ERK pathway: TRAM-01. BMC Cancer. Published online December 2019. doi:10.1186/s12885-019-6442-2
- 3.Hennika T, Hu G, Olaciregui NG, et al. Pre-Clinical Study of Panobinostat in Xenograft and Genetically Engineered Murine Diffuse Intrinsic Pontine Glioma Models. Castro MG, ed. PLoS ONE. Published online January 4, 2017:e0169485. doi:10.1371/journal.pone.0169485
- 4.YOSHIMURA J, ONDA K, TANAKA R, TAKAHASHI H. Clinicopathological Study of Diffuse Type Brainstem Gliomas: Analysis of 40 Autopsy Cases. Neurol Med Chir(Tokyo). Published online 2003:375-382. doi:10.2176/nmc.43.375
- 5.Robertson EG, Wakefield CE, Tsoli M, et al. Parents’ experiences of postmortem tumor donation for high-grade gliomas: benefits and suggested improvements. Neuro-Oncology Advances. Published online January 1, 2021. doi:10.1093/noajnl/vdab087