Induction treatment for diffuse intrinsic pontine glioma, experience of M.D. Anderson Cancer Center

Background: The biology of diffuse intrinsic pontine glioma remains poorly understood and the dismal prognosis has not changed despite various attempts to add chemotherapy to standard radiation. Patients and Methods: A retrospective chart review was carried out of patients with diffuse intrinsic pontine glioma treated at M.D. Anderson Cancer Center from 1998 to 2010, and the data analyzed comparing drug effects aiming to generate hypotheses. Results: A total of 64 patients had diffuse intrinsic pontine glioma as confirmed by radiology review; 28 were male, and age at diagnosis ranged from 1.5 to 16.5 years. All patients received radiation as initial treatment, and 44 had additional treatment during the radiation, with a total of 15 different drug combinations obtained from 15 different individual drugs. The median overall survival after diagnosis was 0.79 years (SD 0.123). Patients treated with the anti-inflammatory agent rofecoxib had inferior survival (p=0.00002). Conclusion: Based on these data, we hypothesize that inflammatory/reactive processes in the tumor might play a beneficial role during radiation and suggest that this be tested in animal models.