Response assessment in paediatric low-grade glioma: recommendations from the Response Assessment in Pediatric Neuro-Oncology (RAPNO) working group

Paediatric low-grade gliomas (also known as pLGG) are the most common type of CNS tumours in children. In general, paediatric low-grade gliomas show clinical and biological features that are distinct from adult low-grade gliomas, and the developing paediatric brain is more susceptible to toxic late...

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Published in:The lancet oncology 2020-06, Vol.21 (6), p.e305-e316
Main Authors: Fangusaro, Jason, Witt, Olaf, Hernáiz Driever, Pablo, Bag, Asim K, de Blank, Peter, Kadom, Nadja, Kilburn, Lindsay, Lober, Robert M, Robison, Nathan J, Fisher, Michael J, Packer, Roger J, Young Poussaint, Tina, Papusha, Ludmila, Avula, Shivaram, Brandes, Alba A, Bouffet, Eric, Bowers, Daniel, Artemov, Anton, Chintagumpala, Murali, Zurakowski, David, van den Bent, Martin, Bison, Brigitte, Yeom, Kristen W, Taal, Walter, Warren, Katherine E
Format: Article
Language:English
Subjects:
Biopsy
Brain cancer
Children
Clinical trials
Committees
Failure to thrive
Glioma
Intracranial pressure
Literature reviews
Neuroimaging
Oncology
Patients
Pediatrics
Signal transduction
Tumors
Visual impairment
Working groups
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Summary:Paediatric low-grade gliomas (also known as pLGG) are the most common type of CNS tumours in children. In general, paediatric low-grade gliomas show clinical and biological features that are distinct from adult low-grade gliomas, and the developing paediatric brain is more susceptible to toxic late effects of the tumour and its treatment. Therefore, response assessment in children requires additional considerations compared with the adult Response Assessment in Neuro-Oncology criteria. There are no standardised response criteria in paediatric clinical trials, which makes it more difficult to compare responses across studies. The Response Assessment in Pediatric Neuro-Oncology working group, consisting of an international panel of paediatric and adult neuro-oncologists, clinicians, radiologists, radiation oncologists, and neurosurgeons, was established to address issues and unique challenges in assessing response in children with CNS tumours. We established a subcommittee to develop consensus recommendations for response assessment in paediatric low-grade gliomas. Final recommendations were based on literature review, current practice, and expert opinion of working group members. Consensus recommendations include imaging response assessments, with additional guidelines for visual functional outcomes in patients with optic pathway tumours. As with previous consensus recommendations, these recommendations will need to be validated in prospective clinical trials.
ISSN:1470-2045
1474-5488
DOI:10.1016/S1470-2045(20)30064-4