Prospective feasibility and safety assessment of surgical biopsy for patients with newly diagnosed diffuse intrinsic pontine glioma.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Gupta Nalin, Goumnerova Liliana C, Manley Peter, Chi Susan N, Neuberg Donna, Puligandla Maneka, Fangusaro Jason, Goldman Stewart, Tomita Tadanori, Alden Tord, DiPatri Arthur, Rubin Joshua B, Gauvain Karen, Limbrick David, Leonard Jeffrey, Geyer J Russel, Leary Sarah, Browd Samuel, Wang Zhihong, Sood Sandeep, Bendel Anne, Nagib Mahmoud, Gardner Sharon, Karajannis Matthias A, Harter David, Ayyanar Kanyalakshmi, Gump William, Bowers Daniel C, Weprin Bradley, MacDonald Tobey J, Aguilera Dolly, Brahma Barunashish, Robison Nathan J, Kiehna Erin, Krieger Mark, Sandler Eric, Aldana Philipp, Khatib Ziad, Ragheb John, Bhatia Sanjiv, Mueller Sabine, Banerjee Anu, Bredlau Amy-Lee, Gururangan Sri, Fuchs Herbert, Cohen Kenneth J, Jallo George, Dorris Kathleen, Handler Michael, Comito Melanie, Dias Mark, Nazemi Kellie, Baird Lissa, Murray Jeff, Lindeman Neal, Hornick Jason L, Malkin Hayley, Sinai Claire, Greenspan Lianne, Wright Karen D, Prados Michael, Bandopadhayay Pratiti, Ligon Keith L, Kieran Mark W
Аннотация
METHODS: Subjects were eligible for the trial if the clinical features and imaging appearance of a newly diagnosed tumor were consistent with a DIPG. Surgical biopsies were performed after enrollment and prior to definitive treatment. All subjects were treated with conventional external beam radiotherapy with bevacizumab, and then stratified to receive bevacizumab with erlotinib or temozolomide, both agents, or neither agent, based on O6-methylguanine-DNA methyltransferase status and epidermal growth factor receptor expression. Whole-genome sequencing and RNA sequencing were performed but not used for treatment assignment.
RESULTS: Fifty-three patients were enrolled at 23 institutions, and 50 underwent biopsy. The median age was 6.4 years, with 24 male and 29 female subjects. Surgical biopsies were performed with a specified technique and no deaths were attributed to the procedure. Two subjects experienced grade 3 toxicities during the procedure (apnea, n = 1; hypertension, n = 1). One subject experienced a neurologic deficit (left hemiparesis) that did not fully recover. Of the 50 tumors biopsied, 46 provided sufficient tissue to perform the study assays (92%, two-stage exact binomial 90% CI: 83%-97%).
CONCLUSIONS: Surgical biopsy of DIPGs is technically feasible, associated with acceptable risks, and can provide biologic data that can inform treatment decisions.