Diffuse Intrinsic Pontine Glioma (DIPG) and Malignant Midline Glioma (MMG) Novel Treatment Clinic / Programme
The new DIPG Centre of Expertise, Zurich (DCEz) is exclusively focused on producing improved therapeutic results for children with DIPG and other malignant midline gliomas leading to an improvement in overall survival times.
The DCEz is synergistically and purposefully attached to our DIPG Research Institute, Zurich (DRIz).
The DCEz and DRIz both reside within the University Children’s Hospital of Zurich, a non-profit hospital supported by the Eleonore Foundation, a philanthropic entity.
Highlight about the Problem
It is recognized worldwide that over 1000 children die every year following being diagnoses with a specific brain cancer called diffuse intrinsic pontine glioma (DIPG). The tumour arises in the pons within the brainstem, but rapidly diffusing and infiltrating the brainstem and throughout the brain by the time of death. The true number of children afflicted is probably more than 4000 globally.
Over the last 50 years, the metric of efficacy has not moved at all and children continue to die from this disease shortly after diagnosis. Radiotherapy -the only standard of care- often results in a transient tumour response but does not significantly impact the long term outcome. The mean overall survival for diagnosed children is about 9-11 months.
Because of the orphan (rarity) nature of the disease, historically, there has been too little medical, scientific or financial resource invested in identifying the cause. More importantly, the rarity of the disease has prohibited the establishment of a single expert centre with the sole focus on the disease.
In addition, there has been a perceived risk to take a biopsy of these tumours located within the brainstem. As a result, our understanding of the tumour biology and how these tumours change in response to therapy has been hampered. However in recent years, due to analyses of post mortem DIPG tumour specimens as well more incidents of upfront tissue sampling, our understanding of the biology of these tumours has significantly improved; it is now clear that DIPG is a heterogeneous group of tumours requiring a personalized therapy approach.
Given the heterogeneity on a molecular level of these tumours, a “one size fits all“ approach has not improved the outcome for these children in the past and wouldn’t do so in the future either.
A novel approach to medicine, using:
- different drug delivery pathways
- combining multiple drug aggregations administered in an optimally sequenced programme of therapy
- marrying the best of medical and scientific knowledge bases
will have much wider implications in the treatment of children with brain cancer and by association in adults too. This novel therapeutic approach requires the close and specialised alignment of a laboratory with a clinic on a wholly integrated basis.
The laboratory will focus solely on researching optimal combinations of existing drugs and optimal sequencing in the administration of those drugs, delivered via several pathways, with a clinic located within the Children’s Hospital of the University, Zürich. The exact timing of drug treatment can be more important than the drug content alone.
As part of the clinic, we will offer second opinions (in person as well as remotely), clinical trial options as well as individualized treatment programmes. The clinic has access to a world class radiation oncology programme as part of the University of Zürich as well as to specialty trained paediatric neurosurgeons, neuro-oncologists, and neurologists who will support the team to care for these patients.