背景：使用BRAF抑制剂（BRAFis）和MEK抑制剂（MEKis）治疗BRAFV600E胶质瘤已越来越多地纳入儿科低级别胶质瘤（PLGG）和儿科高级别胶质瘤（HGG）的临床实践。然而,一些问题仍然没有答案，比如开始靶向治疗的最佳时机，治疗持续时间,停止治疗.鉴于没有临床试验能够解决这些关键问题，我们为BRAFV600E突变的儿科以及青少年和年轻成人(AYA)神经胶质瘤的治疗制定了加拿大共识声明.方法：邀请加拿大神经肿瘤学家参与该共识的制定。在每月的网络全国会议上讨论了共识，并修改算法，直到达成共识。结果：共有26名参与者参与了算法的开发。提出了两种处理算法，一个用于开始治疗，一个用于停止治疗。我们建议大多数BRAFV600E神经胶质瘤患者应预先接受BRAFis±MEKis治疗。在某些情况下可以考虑停止治疗，我们建议慢慢断奶.结论：根据加拿大的专家共识，我们开发了使用BRAFV600E胶质瘤开始治疗儿童和AYA的算法以及停药算法.
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.
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