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01-08-2016 | Clinical Study

Pseudoprogression in children, adolescents and young adults with non-brainstem high grade glioma and diffuse intrinsic pontine glioma

Authors: Fernando Carceller, Lucy A. Fowkes, Komel Khabra, Lucas Moreno, Frank Saran, Anna Burford, Alan Mackay, David T. W. Jones, Volker Hovestadt, Lynley V. Marshall, Sucheta Vaidya, Henry Mandeville, Neil Jerome, Leslie R. Bridges, Ross Laxton, Safa Al-Sarraj, Stefan M. Pfister, Martin O. Leach, Andrew D. J. Pearson, Chris Jones, Dow-Mu Koh, Stergios Zacharoulis

Published in: Journal of Neuro-Oncology | Issue 1/2016

Abstract

Pseudoprogression (PsP) is a treatment-related phenomenon which hinders response interpretation. Its prevalence and clinical impact have not been evaluated in children/adolescents. We assessed the characteristics, risk factors and prognosis of PsP in children/adolescents and young-adults diagnosed with non-brainstem high grade gliomas (HGG) and diffuse intrinsic pontine gliomas (DIPG). Patients aged 1–21 years diagnosed with HGG or DIPG between 1995 and 2012 who had completed radiotherapy were eligible. PsP was assessed according to study-specific criteria and correlated with first-line treatment, molecular biomarkers and survival. Ninety-one patients (47 HGG, 44 DIPG) were evaluable. Median age: 10 years (range, 2–20). Eleven episodes of PsP were observed in 10 patients (4 HGG, 6 DIPG). Rates of PsP: 8.5 % (HGG); 13.6 % (DIPG). Two episodes of PsP were based on clinical findings alone; nine episodes had concurrent radiological changes: increased size of lesions (n = 5), new focal enhancement (n = 4). Temozolomide, MGMT methylation or H3F3A mutations were not found to be associated with increased occurrence of PsP. For HGG, 1-year progression-free survival (PFS) was 41.9 % no-PsP versus 100 % PsP (p = 0.041); differences in 1-year overall survival (OS) were not significant. For DIPG, differences in 1-year PFS and OS were not statistically significant. Hazard ratio (95 %CI) of PsP for OS was 0.551 (0.168–1.803; p = 0.325) in HGG; and 0.308 (0.107–0.882; p = 0.028) in DIPG. PsP occurred in both pediatric HGG and DIPG patients at a comparable rate to adult HGG. PsP was associated with improved 1-yr PFS in HGG patients. PsP had a protective effect upon OS in DIPG patients.

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Title: Pseudoprogression in children, adolescents and young adults with non-brainstem high grade glioma and diffuse intrinsic pontine glioma
Authors: Fernando Carceller
Lucy A. Fowkes
Komel Khabra
Lucas Moreno
Frank Saran
Anna Burford
Alan Mackay
David T. W. Jones
Volker Hovestadt
Lynley V. Marshall
Sucheta Vaidya
Henry Mandeville
Neil Jerome
Leslie R. Bridges
Ross Laxton
Safa Al-Sarraj
Stefan M. Pfister
Martin O. Leach
Andrew D. J. Pearson
Chris Jones
Dow-Mu Koh
Stergios Zacharoulis
Publication date: 01-08-2016
Publisher: Springer US
Published in: Journal of Neuro-Oncology / Issue 1/2016
Print ISSN: 0167-594X
Electronic ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-016-2151-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Pseudoprogression in children, adolescents and young adults with non-brainstem high grade glioma and diffuse intrinsic pontine glioma

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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