Paediatric high-grade glioma (excluding diffuse midline glioma): lines of therapy
5 standard-of-care settings across 3 lines and 4 biomarker subgroups. Rows come from the cancer page's standard of care; the grid places each on its line and subgroup.
Advanced, first line
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Newly diagnosed, child over about three years | Maximal safe resection, focal radiotherapy and temozolomide during and after radiotherapy by extrapolation from adult practice; molecular profiling of every tumour. | NCI PDQ: childhood astrocytomas, other gliomas and glioneuronal tumours | 93 |
Second line
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Recurrence | No standard; re-resection, re-irradiation, clinical trials including CAR-T and oncolytic virus studies. | 7 |
Other settings
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| Age group | Infant-type hemispheric glioma with a fusion | Surgery and fusion-directed therapy: larotrectinib or entrectinib for NTRK fusions, alectinib or lorlatinib for ALK or ROS1 fusions; chemotherapy to defer radiotherapy. | NCI PDQ: childhood astrocytomas, other gliomas and glioneuronal tumours | 86 | |
| BRAF | BRAF V600E-mutant | Dabrafenib plus trametinib (paediatric high-grade glioma cohort 2023; tumour-agnostic approval for BRAF V600E solid tumours from age six). | FDA label 2022 to 2023; NCI PDQ | 88 | |
| MSI-H / dMMR | Constitutional mismatch repair deficiency | PD-1 blockade (nivolumab or pembrolizumab) for hypermutant tumours; germline counselling for the family. | 98 |
Lines and subgroups are parsed from the setting text of each standard-of-care row and can misclassify an unusual phrasing; the row’s own setting is always shown. Guideline chips reflect the NCCN category and ESMO-MCBS grade recorded on the cancer page, checked on its stated date. Not medical advice.