OnCo

Paediatric low-grade glioma: lines of therapy

Cancer page →

4 standard-of-care settings across 4 lines and 2 biomarker subgroups. Rows come from the cancer page's standard of care; the grid places each on its line and subgroup.

LineAll comersBRAF
Early / localised1·
Advanced, first line1·
Second line·1
Third line and beyond·1

Early / localised

SubgroupSettingApproachProducts and trialsEvidence
All comersResectable tumourMaximal safe resection; gross total resection is curative in most and no adjuvant therapy is given. Observation for stable residual disease.40

Advanced, first line

SubgroupSettingApproachProducts and trialsEvidence
All comersUnresectable, no targetable alteration or targeted drug unavailableCarboplatin and vincristine, or weekly vinblastine, to defer radiotherapy; focal conformal or proton radiotherapy is reserved for older children and for progression after systemic options.81

Second line

SubgroupSettingApproachProducts and trialsEvidence
BRAFUnresectable or progressive, BRAF V600EDabrafenib plus trametinib first line (TADPOLE: higher response rate and longer progression-free survival than carboplatin-vincristine; FDA approval March 2023 for patients aged one year and over).84

Third line and beyond

SubgroupSettingApproachProducts and trialsEvidence
BRAFRelapsed or refractory, BRAF fusion or V600ETovorafenib (FIREFLY-1; FDA accelerated approval April 2024 for patients aged six months and over), or a MEK inhibitor such as selumetinib in trials.67

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.