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Bridging Community and Academic Practice: Multidisciplinary Approaches to Diffuse Midline Gliomas

EP. 1: H3K27M-Mutant DMG: Early Symptoms and Imaging Pathway

ByKatherine B. Peters, MD, PhD,Stephen Bagley, MD, MSCE,Mitchel Berger, MD ,Craig Horbinski, MD, PhD ,Suyash Mohan, MD

Experts discuss the clinical complexity of diffuse midline glioma with H3K27M mutation, emphasizing how symptom patterns vary by tumor location—impacting motor, language, or visual function—and highlighting the importance of prompt neuroimaging and multidisciplinary management for early diagnosis and treatment planning.

EP. 2: Imaging Approaches and Clinical Decision-Making in DMG Diagnosis

ByKatherine B. Peters, MD, PhD,Stephen Bagley, MD, MSCE,Mitchel Berger, MD ,Craig Horbinski, MD, PhD ,Suyash Mohan, MD

Experts discuss the complex, multidisciplinary approach to diagnosing and managing gliomas, highlighting the critical role of advanced imaging, rapid communication, and collaborative decision-making to ensure timely, safe, and effective care—especially when tumors are near vital brain regions.

EP. 3: Optimizing DMG Diagnosis with Biopsy Techniques, Biomarker Testing, and Pathology Coordination

ByKatherine B. Peters, MD, PhD,Stephen Bagley, MD, MSCE,Mitchel Berger, MD ,Craig Horbinski, MD, PhD ,Suyash Mohan, MD

Experts discuss the critical importance of conserving biopsy tissue in diffuse midline gliomas, emphasizing the need for strategic use of limited samples, coordination between community and academic centers, and the growing role of advanced molecular diagnostics—including next-generation and liquid biopsy sequencing—to ensure accurate, timely diagnoses despite challenging tumor locations.

EP. 4: Challenges in Diagnosing H3K27M-Mutant DMG in Community Setting

ByKatherine B. Peters, MD, PhD,Stephen Bagley, MD, MSCE,Mitchel Berger, MD ,Craig Horbinski, MD, PhD ,Suyash Mohan, MD

Experts discuss the critical role of accurately identifying the H3K27M mutation in diffuse midline gliomas, emphasizing its prognostic significance, the limitations of traditional diagnostic methods, and the need for early, tissue-conserving molecular testing—particularly next-generation sequencing—to guide treatment planning and ensure proper care across both academic and community settings.

EP. 5: Understanding the Diagnostic Timeline in DMG

ByKatherine B. Peters, MD, PhD,Stephen Bagley, MD, MSCE,Mitchel Berger, MD ,Craig Horbinski, MD, PhD ,Suyash Mohan, MD

Experts discuss the time-sensitive and collaborative process of diagnosing diffuse midline gliomas, highlighting the importance of precise tissue sampling, early molecular testing, and coordinated efforts between neurosurgeons and pathologists to ensure diagnostic accuracy and enable timely, targeted treatment planning.

EP. 6: Additional Considerations for Accurate and Timely Diagnosis of DMG

ByKatherine B. Peters, MD, PhD,Stephen Bagley, MD, MSCE,Mitchel Berger, MD ,Craig Horbinski, MD, PhD ,Suyash Mohan, MD

Experts discuss the meticulous intraoperative handling of limited biopsy samples in diffuse midline glioma, emphasizing the importance of preserving tissue for molecular testing, fostering real-time collaboration between neurosurgeons and pathologists, and leveraging advanced imaging to maximize diagnostic yield while minimizing patient risk.

EP. 7: Multidisciplinary Coordination in DMG Management

ByKatherine B. Peters, MD, PhD,Stephen Bagley, MD, MSCE,Mitchel Berger, MD ,Craig Horbinski, MD, PhD ,Suyash Mohan, MD

Experts discuss the urgency of initiating treatment for diffuse midline gliomas with H3K27M mutations, highlighting the need for seamless multidisciplinary coordination among neurosurgery, neuro-oncology, and radiation oncology to overcome logistical delays, stabilize patients, and ensure timely, personalized care in response to these highly aggressive tumors.

EP. 8: Continuing Multidisciplinary Care Throughout DMG Treatment Sequencing

ByKatherine B. Peters, MD, PhD,Stephen Bagley, MD, MSCE,Mitchel Berger, MD ,Craig Horbinski, MD, PhD ,Suyash Mohan, MD

Experts discuss the pivotal role of tumor boards in managing diffuse midline gliomas, emphasizing the value of multidisciplinary collaboration for treatment planning, imaging interpretation, and ongoing care, while highlighting the importance of consistent follow-up, clinical trial enrollment, and emerging targeted therapies like dordaviprone for patients with H3K27M mutations.

EP. 9: Dordaviprone in Patients with Recurrent H3K27M-Mutant DMG

ByKatherine B. Peters, MD, PhD,Stephen Bagley, MD, MSCE,Mitchel Berger, MD ,Craig Horbinski, MD, PhD ,Suyash Mohan, MD

Experts discuss dordaviprone as a promising new treatment for diffuse midline gliomas with H3K27M mutations, highlighting its dual mechanism of action, encouraging early clinical outcomes in recurrent disease, manageable safety profile, and potential for broader use pending results from ongoing phase III trials.

EP. 10: Monitoring DMG Treatment Response Using RANO 2.0 Criteria

ByKatherine B. Peters, MD, PhD,Stephen Bagley, MD, MSCE,Mitchel Berger, MD ,Craig Horbinski, MD, PhD ,Suyash Mohan, MD

Experts discuss the evolution of the Response Assessment in Neuro-Oncology (RANO) criteria culminating in RANO 2.0, which standardizes treatment response evaluation for gliomas by refining imaging benchmarks, simplifying measurement methods, and addressing challenges in distinguishing progression from treatment effects to enhance consistency in both clinical trials and routine practice.

EP. 11: Emerging Therapies in H3K27M-Mutant DMG

ByKatherine B. Peters, MD, PhD,Stephen Bagley, MD, MSCE,Mitchel Berger, MD ,Craig Horbinski, MD, PhD ,Suyash Mohan, MD

Experts discuss the potential and challenges of CAR-T therapy targeting GD2 for diffuse midline gliomas with H3K27M mutations, highlighting promising but often short-lived responses, significant safety concerns—especially in critical brain regions—and the need for biomarker-driven patient selection to optimize benefits and minimize risks.