Positioning Dordaviprone and the Treatment Landscape in Glioblastoma vs Diffuse Midline Glioma

In this episode, Dr. Chong asks Dr. Shonka which patient profiles make her more or less likely to use dordaviprone. Dr. Shonka’s central point: she initiates dordaviprone as soon as she can justify it after radiation — “the sooner the better” — rather than waiting for clear radiographic progression. She references data suggesting that median overall survival (OS) is better when dordaviprone is started post-radiation but before recurrence is seen on imaging, and she anticipates future data that might support concurrent administration with radiation. Dr. Chong agrees, drawing an analogy to vorasidenib in the INDIGO trial: a Dr.ug that may take 6 to 9 months (or longer) of treatment to produce a negative growth rate and tumor shrinkage rather than simply flattening the trajectory, and so worth starting as early as the indication allows. Dr. Shonka then asks Dr. Chong to compare unmet needs across glioblastoma and DMG. He notes that the upfront standard remains maximal safe resection plus chemoradiation with temozolomide for glioblastoma, and radiation followed by temozolomide for DMG, even though benefit from temozolomide is limited. With dordaviprone now an option at first recurrence in DMG, both agree the most pressing unmet needs sit in two places: later lines of therapy (no clear standard after dordaviprone), and the newly diagnosed setting, where Dr. Chong sees a likely role for dordaviprone as data mature.

In the next episode, “Treatment Sequencing and Response Assessment in High-Grade Glioma,” Dr. Shonka and Dr. Chong walk through second- and third-line decisions and the imaging pitfalls of monitoring DMG.