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Treatment of recurrent diffuse intrinsic pontine glioma: the MD Anderson Cancer Center experience

  • Clinical Study – Patient Study
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Abstract

Recurrent diffuse intrinsic pontine gliomas (DIPG) are traditionally treated with palliative care since no effective treatments have been described for these tumors. Recently, clinical studies have been emerging, and individualized treatment is attempted more frequently. However, an informative way to compare the treatment outcomes has not been established, and historical control data are missing for recurrent disease. We conducted a retrospective chart review of patients with recurrent DIPG treated between 1998 and 2010. Response progression-free survival and possible influencing factors were evaluated. Thirty-one patients were identified who were treated in 61 treatment attempts using 26 treatment elements in 31 different regimens. The most frequently used drugs were etoposide (14), bevacizumab (13), irinotecan (13), nimotuzumab (13), and valproic acid (13). Seven patients had repeat radiation therapy to the primary tumor. Response was recorded after 58 treatment attempts and was comprised of 0 treatment attempts with complete responses, 7 with partial responses, 20 with stable diseases, and 31 with progressive diseases The median progression-free survival after treatment start was 0.16 years (2 months) and was found to be correlated to the prior time to progression but not to the number of previous treatment attempts. Repeat radiation resulted in the highest response rates (4/7), and the longest progression-free survival. These data provide a basis to plan future clinical trials for recurrent DIPG. Repeat radiation therapy should be tested in a prospective clinical study.

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Acknowledgment

This research is supported in part by the National Institutes of Health through MD Anderson’s Cancer Center Support Grant, CA016672.

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Department of Pediatrics, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd, Box 87, Houston, TX, 77030, USA

    Johannes E. Wolff, Michael E. Rytting, Tribhawan S. Vats, Peter E. Zage & Joann L. Ater

  2. Department of Biostatistics, M. D. Anderson Cancer Center, Houston, TX, USA

    Johannes E. Wolff

  3. Department of Pediatrics, Tufts Medical Center, 800 Washington street, Box 014, Boston, MA, 02111, USA

    Johannes E. Wolff

  4. Department of Pediatric Oncology, Texas Children’s Hospital, Houston, TX, USA

    Peter E. Zage

  5. Department of Radiation Oncology, Kosair Children’s Hospital/Norton Healthcare University of Louisville School of Medicine, Louisville, KY, USA

    Shiao Woo

  6. Pediatrics/Hematology/Oncology—H085, Penn State Hershey Children’s Hospital, 500 University Drive, Hershey, PA, 17033-0850, USA

    John Kuttesch

  7. Department of Diagnostic Imaging, M. D. Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA

    Leena Ketonen

  8. Department of Radiation Oncology, M. D. Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA

    Anita Mahajan

Authors
  1. Johannes E. Wolff
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  2. Michael E. Rytting
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  3. Tribhawan S. Vats
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  4. Peter E. Zage
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  5. Joann L. Ater
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  6. Shiao Woo
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  7. John Kuttesch
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  8. Leena Ketonen
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  9. Anita Mahajan
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Corresponding author

Correspondence to Johannes E. Wolff.

Additional information

The patient population presented here overlaps with earlier reports from the same institution as well as several clinical trials in which the patients were enrolled.

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Wolff, J.E., Rytting, M.E., Vats, T.S. et al. Treatment of recurrent diffuse intrinsic pontine glioma: the MD Anderson Cancer Center experience. J Neurooncol 106, 391–397 (2012). https://doi.org/10.1007/s11060-011-0677-3

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  • DOI: https://doi.org/10.1007/s11060-011-0677-3

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