ABSTRACT
Diffuse intrinsic pontine glioma (DIPG) is a rare and deadly childhood malignancy. After 40 years of mostly single-center, often non-randomized trials with variable patient inclusions, there has been no improvement in survival. It is therefore time for international collaboration in DIPG research, to provide new hope for children, parents and medical professionals fighting DIPG. In a first step towards collaboration, in 2011, a network of biologists and clinicians working in the field of DIPG was established within the European Society for Paediatric Oncology (SIOPE) Brain Tumour Group: the SIOPE DIPG Network. By bringing together biomedical professionals and parents as patient representatives, several collaborative DIPG-related projects have been realized. With help from experts in the fields of information technology, and legal advisors, an international, web-based comprehensive database was developed, The SIOPE DIPG Registry and Imaging Repository, to centrally collect data of DIPG patients. As for April 2016, clinical data as well as MR-scans of 694 patients have been entered into the SIOPE DIPG Registry/Imaging Repository. The median progression free survival is 6.0 months (95% Confidence Interval (CI) 5.6-6.4 months) and the median overall survival is 11.0 months (95% CI 10.5-11.5 months). At two and five years post-diagnosis, 10 and 2% of patients are alive, respectively. The establishment of the SIOPE DIPG Network and SIOPE DIPG Registry means a paradigm shift towards collaborative research into DIPG. This is seen as an essential first step towards understanding the disease, improving care and (ultimately) cure for children with DIPG.
Subject(s)
Brain Stem Neoplasms/diagnostic imaging , Glioma/diagnostic imaging , Information Services , International Cooperation , Magnetic Resonance Imaging , Registries , Child , Child, Preschool , Europe , Female , Humans , Image Processing, Computer-Assisted , Male , Pons/diagnostic imaging , Young AdultABSTRACT
Ethical and legal aspects of biobanking continue to be a topic of concern. The String of Pearls Initiative (PSI) helped establish new norms for biobank governance in The Netherlands. This article gives an overview of issues that emerged from the medical-ethical review processes of PSI. The criteria applied to biobanking projects by Ethical Review Boards were derived from the legally prescribed criteria for medical research. However, these criteria were interpreted in radically diverging ways. Key issues included the legal status of prospective research-dedicated biobanks, informed consent, monitoring of the use of biobanks, and alignment of biobanking policies both within and between research departments. The article calls on all actors involved in biobanking to continue to strive for the harmonization of biobanking policies. A certain degree of central coordination is crucial in order to improve on collaborative biobanking initiatives.