Management of children with DIPG: ANZCHOG Position Statement

Tuesday 9 July 2024

The ANZCHOG Central Nervous System (CNS) Tumour Group has recently published a position statement for the management of children with Diffuse Intrinsic Pontine Glioma (DIPG) in Australia and New Zealand.

DIPG is a high-grade glioma and is one of the most aggressive childhood cancers, remaining essentially incurable. Around 20–30 children in Australia and New Zealand are diagnosed with the disease each year.

Highlighting the strong national and Trans-Tasman collaboration, ANZCHOG’s CNS group brings together 20 paediatric neuro‐oncologists from 11 children’s cancer centres and six paediatric brain tumour researchers from Australia and New Zealand, all of whom were involved in the position statement. This group of experts came together to build on their individual experiences and opinions with the objectives of:

• Reviewing and presenting a critical analysis of the current evidence for DIPG;
• Describing current best practice recommendations for the diagnosis and treatment for patients with DIPG; and
• Providing a reference guideline for patients, carers and professionals working in the field of DIPG in Australia and New Zealand.

The main recommendations of the position statement, which has also been reviewed by patient advocates, include:

• All patients with DIPG should be discussed in multidisciplinary neuro-oncology meetings (including pathologists, neuroradiologists, radiation oncologists, neurosurgeons, medical oncologists) at diagnosis and at relapse or progression.
• Radiation therapy to the involved field remains the local and international standard of care treatment.
• Proton therapy does not yield a superior survival outcome compared with photon therapy and patients should undergo radiation therapy with the available modality (photon or proton) at their treatment centre.
• Patients may receive concurrent chemotherapy or radiation sensitising agents as part of a clinical trial.
• Biopsy should be offered to facilitate consideration of experimental therapies and eligibility for clinical trial participation.
• After radiation therapy, each patient should be managed individually with either observation or considered for enrolment on a clinical trial, if eligible, after full discussion with the family.
• Re-irradiation can be considered for progressive disease.

To read the full, open-access article click here.