mTOR: a new therapeutic target for pediatric low-grade glioma?

Pediatric low-grade gliomas (PLGG) represent the most frequent primary brain tumors in children. Despite their low growth rates, a subset may progress or cause substantial morbidity when located in critical brain regions where aggressive surgical resections are not possible. Conventional treatments for young children with unresectable PLGG have avoided radiation therapy due to the significant effects of radiation on the developing brain [1]. Chemotherapy using either carboplatin/vincristine or a lomustine-based regimen is the treatment of choice in the first-line setting [2]. The majority of patients will achieve stable disease or a reduction in tumor size with these low-intensity chemotherapy regimens. A subset of these patients will not have tumor regrowth, probably due to a process of oncogene and chemotherapy induced senescence [3]. However, approximately 50% of patients will have tumors that start to grow again or are refractory to primary therapy [2], underscoring the need to develop new therapeutic options for patients with PLGG.

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