Nimotuzumab for pediatric diffuse intrinsic pontine gliomas

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Diffuse intrinsic pontine gliomas (DIPG) have a poor prognosis:
the median survival rate is less than one year. Radiotherapy is the only
effective treatment affording an overall survival of 6 — 9 months. So far,
no improvement has been achieved with the addition of single/poly-
chemotherapy regimens. An urgent need is to advance in this field, from
both the biological and the clinical points of view.
Areas covered: Among the few studies providing biological information on
DIPG, Gilbertson’s group demonstrated a significant increase in EGFR expres-
sion. The activity of nimotuzumab, a humanized anti-EGFR monoclonal anti-
body, was therefore studied within a Phase II trial in 47 relapsing pediatric
patients with DIPG and high-grade gliomas, showing an interesting, persis-
tent response, especially in the first group treated. A multicenter explor-
atory study combining nimotuzumab and radiotherapy showed disease
control and an overall patient survival similar to previous experiences along
with an improvement in the quality of patient survival and no severe
side effects.
Expert opinion: We recommend considering this combination in the arma-
mentarium against DIPG. It might be improved by adding other target
drugs/low-toxicity chemotherapy regimens with a synergistic effect with the
anti-EGFR component.

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