pLGG Care in Focus: Personalizing Therapy Through Multidisciplinary Collaboration

A multidisciplinary approach is essential in the treatment planning process for pLGGs. Weekly tumor board meetings bring together a wide range of specialists, including surgeons, oncologists, radiologists, pathologists, geneticists, and more. This collaborative environment allows each team member to contribute their expertise, ensuring all potential treatment options are considered. Surgical decisions, for example, are often influenced by insights gained from nonsurgical disciplines, especially when less-invasive strategies—such as a biopsy followed by targeted therapy—may be preferable to aggressive resection.

This approach also helps tailor treatment strategies to the biology of each tumor. Understanding that some tumors may become biologically inactive over time or respond well to systemic therapy may guide the team toward more conservative surgery to preserve neurologic function. Conversely, when tumors are known to be less responsive to medical therapy, surgical teams may opt for more aggressive removal. These nuanced decisions are made possible through the collective knowledge and discussion fostered in a team-based setting, which ensures the patient receives the most appropriate and least harmful intervention possible.

In both initial and recurrent disease settings, the decision to begin or adjust treatment is often based on a combination of imaging, symptoms, and functional assessments, such as vision exams for optic pathway gliomas. Patient and family involvement is also a central part of the treatment process. Families are increasingly knowledgeable and engaged in understanding the available options. In scenarios where multiple treatment paths are viable, incorporating the family’s preferences can be empowering and lead to more informed, collaborative care. The flexibility to adapt treatment as the disease progresses underscores the importance of an open, informed dialogue between families and the care team.