Pediatric low-grade gliomas: implications of the biologic era

Roger J Packer^{1

2

3}, Stephan Pfister^{4

5}, Eric Bouffet⁶, Robert Avery^{1

2

3}, Pratiti Bandopadhayay⁷, Miriam Bornhorst^{1

2

3

8}, Daniel C Bowers⁹, David Ellison^{10

11}, Jason Fangusaro¹², Nicholas Foreman¹³, Maryam Fouladi¹⁴, Amar Gajjar¹¹, Daphne Haas-Kogan¹⁵, Cynthia Hawkins¹⁰, Cheng-Ying Ho¹¹, Eugene Hwang^{1

3

8}, Nada Jabado¹², Lindsay B Kilburn^{3

8}, Alvaro Lassaletta¹³, Keith L Ligon^{14

14}, Maura Massimino^{15

15}, Schouten-van Meeteren¹⁶, Sabine Mueller¹⁷, Theo Nicolaides¹⁷, Giorgio Perilongo¹⁸, Uri Tabori¹⁹, Gilbert Vezina^{2

3

20}, Katherine Warren²¹, Olaf Witt⁴, Yuan Zhu^{1

2

8}, David T Jones⁴, Mark Kieran¹⁴

Affiliations

¹ Center for Neuroscience and Behavioral Medicine, Washington, District of Columbia, USA.
² Gilbert Family Neurofibromatosis Institute, Washington, District of Columbia, USA.
³ Brain Tumor Institute, Washington, District of Columbia, USA.
⁴ Division of Pediatric Neuro-oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
⁵ Department of Pediatric Hematology and Oncology, Heidelberg University Hospital, Heidelberg, Germany.
⁶ Paediatric Neuro-Oncology Program, Research Institute and The Arthur and Sonia Labatt Brain Tumour Research Centre, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
⁷ Department of Pediatrics, Brigham and Women's Hospital, Harvard Medical School, and the Broad Institute, Dana-Farber/Boston Children's Cancer and Blood Disorders Centre, Boston, Massachusetts, USA.
⁸ Center for Cancer and Immunology Research, Washington, District of Columbia, USA.
⁹ Department of Pediatrics, UT Southwestern Medical School, Dallas, Texas, USA.
¹⁰ Department of Pathology, St. Jude Children's Research Hospital, Memphis, Tennessee. USA.
¹¹ Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.
¹² Ann and Robert H. Lurie Children's Hospital of Chicago Department of Pediatric Hematology/Oncology and Stem Cell Transplantation, University of Colorado, Aurora, Colorado, USA.
¹³ Northwestern Feinberg School of Medicine, Chicago, Illinois; Children's Hospital Colorado, University of Colorado, Aurora, Colorado, USA.
¹⁴ Brain Tumor Center, Brain Tumor Translational Research, UC Department of Pediatrics, Cincinnati, Ohio, USA.
¹⁵ Department of Radiation Oncology, Brigham and Women's Hospital, Harvard Medical School, and the Broad Institute, Dana-Farber/Boston Children's Cancer and Blood Disorders Centre, Boston, Massachusetts, USA.
¹⁶ Emma Children's Hospital AMC, Amsterdam-Zuidoost, Netherlands.
¹⁷ Department of Neurology, Pediatrics and Neurosurgery, University of California San Francisco, San Francisco, California, USA.
¹⁸ Department of Woman's and Child's Health, University of Padua, Padua, Italy.
¹⁹ Division of Haematology/Oncology, Research Institute and The Arthur and Sonia Labatt Brain Tumour Research Centre, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
²⁰ Division of Neuroradiology, Washington, District of Columbia, USA.
²¹ National Cancer Institute, Pediatric Oncology and Neuro-Oncology Branches, Bethesda, Maryland, USA.

PMID: 27683733
PMCID: PMC5464436
DOI: 10.1093/neuonc/now209

Review

Pediatric low-grade gliomas: implications of the biologic era

Roger J Packer et al. Neuro Oncol. 2017.

. 2017 Jun 1;19(6):750-761.

doi: 10.1093/neuonc/now209.

Authors

Affiliations

¹ Center for Neuroscience and Behavioral Medicine, Washington, District of Columbia, USA.
² Gilbert Family Neurofibromatosis Institute, Washington, District of Columbia, USA.
³ Brain Tumor Institute, Washington, District of Columbia, USA.
⁴ Division of Pediatric Neuro-oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
⁵ Department of Pediatric Hematology and Oncology, Heidelberg University Hospital, Heidelberg, Germany.
⁶ Paediatric Neuro-Oncology Program, Research Institute and The Arthur and Sonia Labatt Brain Tumour Research Centre, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
⁷ Department of Pediatrics, Brigham and Women's Hospital, Harvard Medical School, and the Broad Institute, Dana-Farber/Boston Children's Cancer and Blood Disorders Centre, Boston, Massachusetts, USA.
⁸ Center for Cancer and Immunology Research, Washington, District of Columbia, USA.
⁹ Department of Pediatrics, UT Southwestern Medical School, Dallas, Texas, USA.
¹⁰ Department of Pathology, St. Jude Children's Research Hospital, Memphis, Tennessee. USA.
¹¹ Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.
¹² Ann and Robert H. Lurie Children's Hospital of Chicago Department of Pediatric Hematology/Oncology and Stem Cell Transplantation, University of Colorado, Aurora, Colorado, USA.
¹³ Northwestern Feinberg School of Medicine, Chicago, Illinois; Children's Hospital Colorado, University of Colorado, Aurora, Colorado, USA.
¹⁴ Brain Tumor Center, Brain Tumor Translational Research, UC Department of Pediatrics, Cincinnati, Ohio, USA.
¹⁵ Department of Radiation Oncology, Brigham and Women's Hospital, Harvard Medical School, and the Broad Institute, Dana-Farber/Boston Children's Cancer and Blood Disorders Centre, Boston, Massachusetts, USA.
¹⁶ Emma Children's Hospital AMC, Amsterdam-Zuidoost, Netherlands.
¹⁷ Department of Neurology, Pediatrics and Neurosurgery, University of California San Francisco, San Francisco, California, USA.
¹⁸ Department of Woman's and Child's Health, University of Padua, Padua, Italy.
¹⁹ Division of Haematology/Oncology, Research Institute and The Arthur and Sonia Labatt Brain Tumour Research Centre, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
²⁰ Division of Neuroradiology, Washington, District of Columbia, USA.
²¹ National Cancer Institute, Pediatric Oncology and Neuro-Oncology Branches, Bethesda, Maryland, USA.

PMID: 27683733
PMCID: PMC5464436
DOI: 10.1093/neuonc/now209

Abstract

For the past decade, it has been recognized that pediatric low-grade gliomas (LGGs) and glial-neuronal tumors carry distinct molecular alterations with resultant aberrant intracellular signaling in the Ras-mitogen-activated protein kinase pathway. The conclusions and recommendations of a consensus conference of how best to integrate the growing body of molecular genetic information into tumor classifications and, more importantly, for future treatment of pediatric LGGs are summarized here. There is uniform agreement that molecular characterization must be incorporated into classification and is increasingly critical for appropriate management. Molecular-targeted therapies should be integrated expeditiously, but also carefully into the management of these tumors and success measured not only by radiographic responses or stability, but also by functional outcomes. These trials need to be carried out with the caveat that the long-term impact of molecularly targeted therapy on the developing nervous system, especially with long duration treatment, is essentially unknown.

Keywords: low-grade glioma; neurofibromatosis type 1; pediatric brain tumor; pilocytic astrocytoma; RAS/MAPK pathway.

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References

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Pediatric low-grade gliomas: implications of the biologic era

Affiliations

Pediatric low-grade gliomas: implications of the biologic era

Authors

Affiliations

Abstract

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical

Research Materials

Miscellaneous