Novel “T-Dimension” Therapies for Pediatric Optic Pathway Glioma: A Timely, Targeted, and Tailored Treatment Trend

IF 0.9 4区医学 Q4 CLINICAL NEUROLOGY

Pediatric Neurosurgery Pub Date : 2022-05-04 DOI:10.1159/000524873

Alice Giotta Lucifero, S. Elbabaa, Matías Baldoncini, Nunzio Bruno, S. Savasta, G. Marseglia, S. Luzzi

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引用次数: 0

Abstract

Introduction: Novel targeted and tailored therapies can substantially improve the prognosis for optic pathway glioma (OPG), especially when implemented in a timely manner. However, their tremendous potential remains underestimated. Therefore, in this study, we provide an updated overview of the clinical trials, current trends, and future perspectives for OPG’s novel therapeutic strategies. Methods: We completed an extensive literature review using the PubMed, MEDLINE, and ClinicalTrials.gov databases. We analyzed and reported the data following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results: Thioguanine, procarbazine, lomustine, and vincristine/vinblastine, as well as cisplatin-etoposide, provided excellent results in advanced-phase trials. Selumetinib and trametinib, two oral MEK inhibitors, have been approved for recurrent or refractory OPGs in association with the angiogenetic inhibitor bevacizumab. Among the mTOR inhibitors, everolimus and sirolimus showed the best results. Stereotactic radiosurgery and proton beam radiation therapy have advantages over conventional radiotherapy regimens. Timely treatment is imperative for acute visual symptoms with evidence of tumor progression. This latest evidence can help define a novel “T-Dimension” for pediatric OPG therapies. Conclusion: The novel “T-Dimension” for pediatric OPGs is based on recent evidence-based treatments, including combination chemotherapy regimens, molecular targeted therapies, stereotactic radiosurgery, and proton beam radiation therapy. Additional clinical trials are essential for validating each of these new therapies.

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儿童视神经胶质瘤的新型“t维”疗法:及时、有针对性和量身定制的治疗趋势

新颖的靶向和量身定制的治疗方法可以显著改善视神经胶质瘤(OPG)的预后，特别是在及时实施时。然而，它们的巨大潜力仍被低估。因此，在本研究中，我们对OPG新治疗策略的临床试验、当前趋势和未来前景进行了最新概述。方法:我们使用PubMed、MEDLINE和ClinicalTrials.gov数据库完成了广泛的文献综述。我们按照系统评价和荟萃分析指南的首选报告项目分析和报告数据。结果:硫鸟嘌呤、丙卡嗪、洛莫司汀、长春新碱/长春花碱以及顺铂-依托泊苷在晚期试验中提供了出色的结果。Selumetinib和trametinib是两种口服MEK抑制剂，已被批准与血管生成抑制剂贝伐单抗联合用于复发性或难治性OPGs。在mTOR抑制剂中，依维莫司和西罗莫司的效果最好。立体定向放射外科和质子束放射治疗比传统的放射治疗方案有优势。对于有肿瘤进展迹象的急性视觉症状，及时治疗是必要的。这一最新证据有助于定义儿科OPG治疗的新“t维度”。结论:儿童OPGs的新“t维度”是基于最近的循证治疗，包括联合化疗方案、分子靶向治疗、立体定向放射手术和质子束放射治疗。额外的临床试验对于验证每一种新疗法都是必不可少的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Neurosurgery 医学-临床神经学

CiteScore

1.30

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： Articles in ''Pediatric Neurosurgery'' strives to publish new information and observations in pediatric neurosurgery and the allied fields of neurology, neuroradiology and neuropathology as they relate to the etiology of neurologic diseases and the operative care of affected patients. In addition to experimental and clinical studies, the journal presents critical reviews which provide the reader with an update on selected topics as well as case histories and reports on advances in methodology and technique. This thought-provoking focus encourages dissemination of information from neurosurgeons and neuroscientists around the world that will be of interest to clinicians and researchers concerned with pediatric, congenital, and developmental diseases of the nervous system.