Evidence map›Paper›PMID 38743009›Full record

ArticleNeuro-oncology2024

Resistance, rebound, and recurrence regrowth patterns in pediatric low-grade glioma treated by MAPK inhibition: A modified Delphi approach to build international consensus-based definitions-International Pediatric Low-Grade Glioma Coalition.

Patricia O'Hare, Tabitha Cooney, Peter de Blank, David H Gutmann, Mark Kieran, Till Milde, Jason Fangusaro, Michael Fisher, Shivaram Avula, Roger Packer and 23 more

Abstract readConsensus Statement
In one paragraph

Article in Neuro-oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Article
  6. Review
  7. RAS/MAPK inhibition in pediatric gliomas.Neuro-oncology advances · 2026
    Review
  8. Review
  9. Article
  10. Review
  11. Review
  12. Article
  13. Significant clinical and radiologic response to targeted therapy in pediatric cervicomedullary low-grade gliomas harboring the BRAFV600E mutation.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2025
    Article
  14. Article
  15. Article
  16. Central Nervous System Tumors in Adolescents and Young Adults.Current neurology and neuroscience reports · 2025
    Review
  17. Article
  18. Review
  19. Review
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

33 authors.

Patricia O'HareDepartment of Paediatric Oncology, Royal Belfast Hospital for Sick Children, Northern Ireland, UK.
Tabitha CooneyDana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts, USA.
Peter de BlankDana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts, USA.
David H GutmannDepartment of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA.
Mark KieranDay One Biopharmaceuticals, Boston, Massachusetts, USA.
Till MildeClinical Pediatric Oncology, Hopp Children's Cancer Center (KiTZ), Heidelberg, Germany.
Jason FangusaroAflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta and Emory University School of Medicine, Atlanta, Georgia, USA.
Michael FisherDivision of Oncology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Shivaram AvulaDepartment of Radiology, Alder Hey Children's NHS Foundation Trust, Liverpool, UK.
Roger PackerBrain Tumor Institute, Center for Neuroscience and Behavioral Medicine, Children's National Hospital, Washington, District of Columbia, USA.
Kohei FukuokaDepartment of Hematology/Oncology, Saitama Children's Medical Center, Saitama, Japan.ORCID 0000-0003-2568-0877
Kshitij MankadDepartment of Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust, Department of Radiology, London, UK.
Sabine MuellerDepartment of Neurology, Neurosurgery and Pediatrics, University of California, San Francisco, San Francisco, California, USA.
Angela J WaandersDepartment of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Enrico OpocherPaediatric Haematology, Oncology and Stem Cell Transplant Division, Padua University Hospital, Padua, Italy.
Eric BouffetThe Hospital for Sick Children and Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada.ORCID 0000-0002-6832-6539
Eric RaabeDivision of Pediatric Oncology, Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Natacha Entz WerlePediatric Onco-Hematology Department, University Hospital of Strasbourg. UMR CNRS 7021, University of Strasbourg, Strasbourg, France.
Amedeo A AziziDepartment of Pediatrics and Adolescent Medicine and Comprehensive Centre of Pediatrics, Medical University of Vienna, Vienna, Austria.
Nathan J RobisonDivision of Hematology & Oncology, Children's Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, California, USA.
Pablo Hernáiz DrieverCharité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, German HIT-LOGGIC-Registry for LGG in children and adolescents, Department of Pediatric Oncology/Hematology, Berlin, Germany.
Mark RussoNovartis Pharmaceuticals Corporation, East Hanover, New Jersey, USA.
Netteke SchoutenPrincess Maxima Center for Pediatric Oncology, Utrecht, Netherlands.
Cornelis M van TilburgClinical Pediatric Oncology, Hopp Children's Cancer Center (KiTZ), Heidelberg, Germany.
Astrid SehestedDepartment of Paediatrics and Adolescent Medicine, The University Hospital Rigshospitalet, Copenhagen, Denmark.
Jacques GrillDepartment of Pediatric and Adolescent Oncology, Villejuif, France.ORCID 0000-0003-4773-3001
Pratiti BandopadhayayDana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts, USA.
John-Paul KildayThe Centre for Paediatric, Teenage and Young Adult Cancer, Institute of Cancer Sciences, University of Manchester, and Royal Manchester Children's Hospital, Manchester, UK.ORCID 0000-0002-0539-215X
Olaf WittClinical Pediatric Oncology, Hopp Children's Cancer Center (KiTZ), Heidelberg, Germany.
David M AshleyDepartment of Neurosurgery, The Preston Robert Tisch Brain Tumor Center. Pediatric Neuro-Oncology, Preuss Laboratory for Brain Tumor Research, Durham, North Carolina, USA.
Birgit Betina Ertl-WagnerDepartment of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada.
Uri TaboriThe Hospital for Sick Children and Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada.ORCID 0000-0002-5019-2683
Darren R HargraveUCL Great Ormond Street Institute of Child Health, Great Ormond Street Hospital for Children, London, UK.ORCID 0000-0001-8219-9807

Funding

National Institute for Health Research/Biomedical Research Center at Great Ormond Street Hospital for ChildrenNHS Foundation TrustUniversity College London
6 · The paper itself

Abstract

Pediatric low-grade glioma (pLGG) is the most common childhood brain tumor group. The natural history, when curative resection is not possible, is one of a chronic disease with periods of tumor stability and episodes of tumor progression. While there is a high overall survival rate, many patients experience significant and potentially lifelong morbidities. The majority of pLGGs have an underlying activation of the RAS/MAPK pathway due to mutational events, leading to the use of molecularly targeted therapies in clinical trials, with recent regulatory approval for the combination of BRAF and MEK inhibition for BRAFV600E mutated pLGG. Despite encouraging activity, tumor regrowth can occur during therapy due to drug resistance, off treatment as tumor recurrence, or as reported in some patients as a rapid rebound growth within 3 months of discontinuing targeted therapy. Definitions of these patterns of regrowth have not been well described in pLGG. For this reason, the International Pediatric Low-Grade Glioma Coalition, a global group of physicians and scientists, formed the Resistance, Rebound, and Recurrence (R3) working group to study resistance, rebound, and recurrence. A modified Delphi approach was undertaken to produce consensus-based definitions and recommendations for regrowth patterns in pLGG with specific reference to targeted therapies.

Indexed as

Brain NeoplasmsDelphi TechniqueDrug Resistance, NeoplasmGliomaNeoplasm Recurrence, LocalChildHumansNeoplasm GradingProtein Kinase InhibitorsProtein Kinase Inhibitorschildlow-grade gliomaMAPKpediatric brain tumorreboundrecurrenceresistance

Identifiers

PMID38743009
PMCPMC11300023

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.