Canadian Consensus for Treatment of BRAF <i>V600E</i> Mutated Pediatric and AYA Gliomas

Craig Erker; Magimairajan Issai Vanan; Valérie Larouche; Liana Nobre; Chantel Cacciotti; Stéphanie Vairy; Shayna Zelcer; Adam Fleming; Eric Bouffet; Nada Jabado; Geneviève Legault; Samuele Renzi; Tara McKeown; Bruce Crooks; Nirav Thacker; Vijay Ramaswamy; Hallie Coltin; Lucie Lafay-Cousin; Sylvia Cheng; Juliette Hukin; Seth Andrew Climans; Mary Jane Lim-Fat; Sarah McKillop; Sarah Lapointe; Mélanie Alves; Julie Bennett; Uri Tabori; Sébastien Perreault

doi:10.3390/curroncol31070299

Current Oncology (Jul 2024)

Canadian Consensus for Treatment of BRAF <i>V600E</i> Mutated Pediatric and AYA Gliomas

Craig Erker,
Magimairajan Issai Vanan,
Valérie Larouche,
Liana Nobre,
Chantel Cacciotti,
Stéphanie Vairy,
Shayna Zelcer,
Adam Fleming,
Eric Bouffet,
Nada Jabado,
Geneviève Legault,
Samuele Renzi,
Tara McKeown,
Bruce Crooks,
Nirav Thacker,
Vijay Ramaswamy,
Hallie Coltin,
Lucie Lafay-Cousin,
Sylvia Cheng,
Juliette Hukin,
Seth Andrew Climans,
Mary Jane Lim-Fat,
Sarah McKillop,
Sarah Lapointe,
Mélanie Alves,
Julie Bennett,
Uri Tabori,
Sébastien Perreault

Affiliations

Craig Erker: Department of Pediatrics, Dalhousie University, Halifax, NS B3H 4R2, Canada
Magimairajan Issai Vanan: Pediatric Neuro-Oncology, Division of Pediatric Hematology-Oncology and BMT, Cancer Care Manitoba, 3a Department of Pediatrics and Child Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
Valérie Larouche: Department of Pediatric Hemato-Oncology, CHU de Québec-Université Laval, Quebec City, QC G1V 4G2, Canada
Liana Nobre: Department of Pediatrics, University of Alberta, Edmonton, AB T6G 2R3, Canada
Chantel Cacciotti: Division of Hematology/Oncology, Department of Pediatrics, London Health Sciences Centre & Western University, London, ON N6A 5A5, Canada
Stéphanie Vairy: Department of Pediatrics, Division of Pediatric Hematology, CHU Sherbrooke, QC J1H 5N4, Canada
Shayna Zelcer: Division of Hematology/Oncology, Department of Pediatrics, London Health Sciences Centre & Western University, London, ON N6A 5A5, Canada
Adam Fleming: McMaster Children’s Hospital, Hamilton, ON L8N 3Z5, Canada
Eric Bouffet: Department of Pediatrics, University of Toronto, Toronto, ON M5S 1A1, Canada
Nada Jabado: Montreal Children’s Hospital, Montréal, QC H4A 3J1, Canada
Geneviève Legault: Montreal Children’s Hospital, Montréal, QC H4A 3J1, Canada
Samuele Renzi: Department of Pediatric Hemato-Oncology, CHU de Québec-Université Laval, Quebec City, QC G1V 4G2, Canada
Tara McKeown: Department of Pediatrics, University of Toronto, Toronto, ON M5S 1A1, Canada
Bruce Crooks: Department of Pediatrics, Dalhousie University, Halifax, NS B3H 4R2, Canada
Nirav Thacker: Division of Hematology/Oncology, CHEO, Ottawa, ON K1H 8L1, Canada
Vijay Ramaswamy: Department of Pediatrics, University of Toronto, Toronto, ON M5S 1A1, Canada
Hallie Coltin: Division of Hematology Oncology, CHU Sainte-Justine, Montréal, QC H3T 1C5, Canada
Lucie Lafay-Cousin: Alberta Children’s Hospital, Calgary, AB T3B 6A8, Canada
Sylvia Cheng: B.C. Children’s Hospital, Vancouver, BC V6H 3N1, Canada
Juliette Hukin: B.C. Children’s Hospital, Vancouver, BC V6H 3N1, Canada
Seth Andrew Climans: Department of Oncology, Western University, London, ON N6A 3K7, Canada
Mary Jane Lim-Fat: Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON M5S 1A1, Canada
Sarah McKillop: Women and Children’s Health Research Institute, University of Alberta, Edmonton, AB T6G 2R3, Canada
Sarah Lapointe: Division of Neurology, Department of Neurosciences, Montreal, QC H3A 2B4, Canada
Mélanie Alves: Department of Neurosciences, University of Montreal, Montréal, QC H3T 1J4, Canada
Julie Bennett: Department of Pediatrics, University of Toronto, Toronto, ON M5S 1A1, Canada
Uri Tabori: Department of Pediatrics, University of Toronto, Toronto, ON M5S 1A1, Canada
Sébastien Perreault: Department of Neurosciences, University of Montreal, Montréal, QC H3T 1J4, Canada

DOI: https://doi.org/10.3390/curroncol31070299
Journal volume & issue: Vol. 31, no. 7
pp. 4022 – 4029

Abstract

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Background: The treatment of BRAF V600E gliomas with BRAF inhibitors (BRAFis) and MEK inhibitors (MEKis) has been increasingly integrated into clinical practice for pediatric low-grade gliomas (PLGGs) and pediatric high-grade gliomas (HGGs). However, some questions remain unanswered, such as the best time to start targeted therapy, duration of treatment, and discontinuation of therapy. Given that no clinical trial has been able to address these critical questions, we developed a Canadian Consensus statement for the treatment of BRAF V600E mutated pediatric as well as adolescent and young adult (AYA) gliomas. Methods: Canadian neuro-oncologists were invited to participate in the development of this consensus. The consensus was discussed during monthly web-based national meetings, and the algorithms were revised until a consensus was achieved. Results: A total of 26 participants were involved in the development of the algorithms. Two treatment algorithms are proposed, one for the initiation of treatment and one for the discontinuation of treatment. We suggest that most patients with BRAF V600E gliomas should be treated with BRAFis ± MEKis upfront. Discontinuation of treatment can be considered in certain circumstances, and we suggest a slow wean. Conclusions: Based on expert consensus in Canada, we developed algorithms for treatment initiation of children and AYA with BRAF V600E gliomas as well as a discontinuation algorithm.

Published in Current Oncology

ISSN: 1198-0052 (Print); 1718-7729 (Online)
Publisher: MDPI AG
Country of publisher: Switzerland
LCC subjects: Medicine: Internal medicine: Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Website: https://www.mdpi.com/journal/curroncol

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