Bridging the Gap Between Community and Academic Settings to Advance DMG Care

Funding support provided by Chimerix/Jazz Pharmaceuticals. Content independently developed and published by OncLive.

A major challenge for community oncologists treating diffuse midline glioma is ensuring timely access to clinical trials, which often requires close collaboration with academic centers. Effective communication is essential, as community providers can engage tertiary centers early to determine trial eligibility and re-establish contact when patients experience radiographic changes. Building these relationships helps avoid missed opportunities for patients to enroll in research protocols while still receiving standard-of-care treatment locally.

Several clinical insights were emphasized for managing these difficult tumors. With dordaviprone, physicians are encouraged to be patient, as responses may take seven to eight months to emerge, sometimes after an initial phase of radiographic progression. Neuro-oncology care for diffuse midline gliomas demands 24/7 readiness, and community practices are advised to establish strong partnerships with academic groups to provide backup in emergencies. Additionally, testing for MGMT promoter methylation is generally unnecessary in pediatric cases, since it is almost always absent, allowing tissue to be conserved for next-generation sequencing instead.

Imaging advances and biomarker development remain critical needs. Non-invasive diagnostics, such as identifying metabolic markers like 2-hydroxyglutarate in other gliomas, highlight the potential for similar approaches in diffuse midline gliomas. Given that only a fraction of patients respond to current therapies, identifying predictive biomarkers upfront is essential to guide treatment selection and trial enrollment. Continued collaboration between community and academic providers, combined with research into novel imaging and molecular tools, offers the best path forward for improving outcomes in this challenging disease.