Diffuse intrinsic pontine glioma (DIPG) was first described by Harvey Cushing, the father of modern neurosurgery, a century ago. Since then, the classification of this tumor changed significantly, as it is now part of the broader family of diffuse midline gliomas (DMGs), a heterogeneous group of tumors of midline structures encompassing the entire rostro-caudal space, from the thalamus to the spinal cord. DMGs are characterized by various epigenetic events that lead to chromatin remodeling similarities, as two decades of studies made possible by increased tissue availability showed. This new understanding of tumor (epi)biology is now driving novel clinical trials that rely on targeted agents, with finally real hopes for a change in an otherwise unforgiving prognosis. This biological discovery is being paralleled with equally exciting work in therapeutic drug delivery. Invasive and noninvasive platforms have been central to early phase clinical trials with a promising safety track record and anecdotal benefits in outcome.
弥漫性内生性桥脑胶质瘤（DIPG）于一个世纪前由现代神经外科之父哈维·库欣首次描述。此后，该肿瘤的分类发生了显著变化，现已被纳入更广泛的弥漫性中线胶质瘤（DMG）家族。DMG是一组异质性中线结构肿瘤，其范围覆盖从丘脑到脊髓的整个头尾空间。近二十年来，随着组织样本可及性的提高，研究证实DMG具有多种表观遗传事件，这些事件导致其染色质重塑特征呈现相似性。基于对肿瘤（表观）生物学的这一新认识，目前正在开展以靶向药物为核心的新型临床试验，这为改变原本严峻的预后带来了切实希望。与此同时，治疗药物递送领域也取得了同样令人振奋的进展。侵入性与非侵入性递送平台已成为早期临床试验的关键，其安全记录良好，并在临床结局中显示出积极的个案疗效。
Diffuse Midline Gliomas: Challenges and New Strategies in a Changing Clinical Landscape
肿瘤(癌症)患者之家