Publications by authors named "Neevika Manoharan"

The objective of this systematic review was to identify the medication information needs and preferences of caregivers of children with cancer and explore the medication management challenges these caregivers experienced. We conducted a systematic search of three databases (Cumulative Index to Nursing and Allied Health Literature, Embase, and Medline) for studies published from database inception to February 27, 2024, and assessed the medication information needs of caregivers of children with cancer. The methodological quality of qualitative studies was assessed using the Critical Appraisal Skills Programme Qualitative Research Checklist.

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Article Synopsis
  • Recent research indicates that precision medicine is effective in developing new treatment options for childhood cancers, specifically for high-risk patients with a low expected cure rate.
  • In a study involving 384 patients, 67% received recommendations for precision-guided treatment (PGT), leading to a 36% objective response rate and better 2-year progression-free survival compared to standard treatments.
  • The most significant benefits from PGT were observed in cases targeting specific genetic markers and when treatment started before disease progression.
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Article Synopsis
  • The Australian and New Zealand Children's Haematology and Oncology Group (ANZCHOG) aims to provide access to cutting-edge clinical trials for all pediatric cancers, particularly focusing on diffuse intrinsic pontine gliomas (DIPGs), which have a very low survival rate of less than 10% at two years.
  • Despite advances in research, DIPG remains a challenging cancer without a cure, necessitating new therapeutic approaches in surgery, imaging, and treatment methods.
  • It is recommended that all DIPG cases be reviewed by a team of specialists, with radiation therapy as the standard treatment, and that patients are considered for clinical trials and innovative treatments based on individual
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Background: Recurrent brain tumors are the leading cause of cancer death in children. Indoleamine 2,3-dioxygenase (IDO) is a targetable metabolic checkpoint that, in preclinical models, inhibits anti-tumor immunity following chemotherapy.

Methods: We conducted a phase I trial (NCT02502708) of the oral IDO-pathway inhibitor indoximod in children with recurrent brain tumors or newly diagnosed diffuse intrinsic pontine glioma (DIPG).

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Unlabelled: Diffuse midline gliomas (DMG), including diffuse intrinsic pontine gliomas (DIPG), are the most lethal of childhood cancers. Palliative radiotherapy is the only established treatment, with median patient survival of 9 to 11 months. ONC201 is a DRD2 antagonist and ClpP agonist that has shown preclinical and emerging clinical efficacy in DMG.

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Diffuse midline gliomas (DMG), including diffuse intrinsic pontine gliomas (DIPGs), are the most lethal of childhood cancers. Palliative radiotherapy is the only established treatment, with median patient survival of 9-11 months. ONC201 is a DRD2 antagonist and ClpP agonist that has shown preclinical and emerging clinical efficacy in DMG.

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The mitogen-activated protein kinase (MAPK) pathway signaling pathway is one of the most commonly mutated pathways in human cancers. In particular, BRAF alterations result in constitutive activation of the rapidly accelerating fibrosarcoma-extracellular signal-regulated kinase-MAPK significant pathway, leading to cellular proliferation, survival, and dedifferentiation. The role of BRAF mutations in oncogenesis and tumorigenesis has spurred the development of targeted agents, which have been successful in treating many adult cancers.

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Diffuse midline gliomas (DMG) harbouring H3K27M mutation are paediatric tumours with a dismal outcome. Recently, a new subtype of midline gliomas has been described with similar features to DMG, including loss of H3K27 trimethylation, but lacking the canonical H3K27M mutation (H3-WT). Here, we report a cohort of five H3-WT tumours profiled by whole-genome sequencing, RNA sequencing and DNA methylation profiling and combine their analysis with previously published cases.

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pLGGs are a group of tumors for which the era of molecular diagnostics has truly shifted treatment paradigms and patient care. The discovery that this group of tumors is driven by single-gene alterations/fusions in the MAPK pathway has resulted in relatively rapid translation into targeted therapy options for patients with this often chronic disease. This translation has been facilitated through efforts of multiple collaboratives and consortia and has led to the development of clinical trials testing the role of targeted therapies in pLGG.

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Diffuse leptomeningeal glioneuronal tumours (DLGNT) represent rare enigmatic CNS tumours of childhood. Most patients with this disease share common radiological and histopathological features but the clinical course of this disease is variable. A radiological hallmark of this disease is widespread leptomeningeal enhancement that may involve the entire neuroaxis with predilection for the posterior fossa and spine.

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Background: Ependymoma is the third most common malignant CNS tumor in children. Despite multimodal therapy, prognosis of relapsed ependymoma remains poor. Approaches to therapy for relapsed ependymoma are varied.

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Purpose: Pediatric low-grade gliomas (pLGGs) are the most common CNS tumor of childhood and comprise a heterogenous group of tumors. Children with progressive pLGG often require numerous treatment modalities including surgery, chemotherapy, rarely radiation therapy and, more recently, molecularly targeted therapy. We describe our institutional experience using the MEK inhibitor, trametinib, for recurrent/progressive pLGGs.

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