|
1
|
Mueller S, Fangusaro J, Thomas AO, Jacques TS, Bandopadhayay P, de Blank P, Packer RJ, Fouladi M, van Meeteren AS, Jones D, Perry A, Nakano Y, Hargrave D, Riedl D, Robison NJ, Partanen M, Fisher MJ, Witt O. Consensus framework for conducting phase I/II clinical trials for children, adolescents, and young adults with pediatric low-grade glioma: Guidelines established by the International Pediatric Low-Grade Glioma Coalition Clinical Trial Working Group. Neuro Oncol 2024; 26:407-416. [PMID: 38146999 PMCID: PMC10912006 DOI: 10.1093/neuonc/noad227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2023] Open
Abstract
Within the last few decades, we have witnessed tremendous advancements in the study of pediatric low-grade gliomas (pLGG), leading to a much-improved understanding of their molecular underpinnings. Consequently, we have achieved successful milestones in developing and implementing targeted therapeutic agents for treating these tumors. However, the community continues to face many unknowns when it comes to the most effective clinical implementation of these novel targeted inhibitors or combinations thereof. Questions encompassing optimal dosing strategies, treatment duration, methods for assessing clinical efficacy, and the identification of predictive biomarkers remain unresolved. Here, we offer the consensus of the international pLGG coalition (iPLGGc) clinical trial working group on these important topics and comment on clinical trial design and endpoint rationale. Throughout, we seek to standardize the global approach to early clinical trials (phase I and II) for pLGG, leading to more consistently interpretable results as well as enhancing the pace of novel therapy development and encouraging an increased focus on functional endpoints as well and quality of life for children faced with this disease.
Collapse
Affiliation(s)
- Sabine Mueller
- Department of Neurology, Neurological Surgery and Pediatrics, University of California, San Francisco, San Francisco, California, USA
- Department of Pediatrics, University Children’s Hospital, University of Zurich, Zürich, Switzerland
| | - Jason Fangusaro
- Department of Hematology and Oncology, Children’s Healthcare of Atlanta and Emory University, Atlanta, Georgia, USA
| | - Arzu Onar Thomas
- Department of Biostatistics, St Jude Children’s Research Hospital, Memphis, Tennessee, USA
| | - Thomas S Jacques
- UCL Great Ormond Street Institute of Child Health and Histopathology Department, Developmental Biology and Cancer Programme, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Pratiti Bandopadhayay
- Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, Boston, Massachusetts, USA
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | - Peter de Blank
- Department of Pediatrics, University of Cincinnati Medical Center and Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
| | - Roger J Packer
- Brain Tumor Institute, Washington DC, USA
- Gilbert Family Neurofibromatosis Institute, Washington DC, USA
- Center for Neuroscience and Behavioral Medicine, Children’s National Hospital, Washington, District of Columbia, USA
| | - Maryam Fouladi
- Pediatric Brain Tumor Program, Division of Hematology, Oncology, and Bone Marrow Transplant, Nationwide Children’s Hospital, Columbus, Ohio, USA
| | | | - David Jones
- Hopp Children’s Cancer Center Heidelberg (KiTZ), Heidelberg, Germany
| | - Arie Perry
- Departments of Pathology and Neurological Surgery, University of California San Francisco, San Francisco, California, USA
| | - Yoshiko Nakano
- Division of Haematology/Oncology, Hospital for Sick Children, Toronto, Canada
| | - Darren Hargrave
- Department of Paediatric Oncology, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - David Riedl
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, University Hospital of Psychiatry II, Medical University of Innsbruck, Innsbruck, Austria
- Ludwig Boltzmann Institute for Rehabilitation Research, Vienna, Austria
| | - Nathan J Robison
- Division of Hematology and Oncology, Children’s Hospital Los Angeles, Los Angeles, California, USA
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Marita Partanen
- Department of Research, Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Michael J Fisher
- Division of Oncology, Children’s Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Olaf Witt
- Hopp Children’s Cancer Center (KiTZ), National Center for Tumor Diseases (NCT), German Cancer Research Center (DKFZ) and University Hospital, Heidelberg, Germany
| |
Collapse
|