CRUK/21/010: LOGGIC Core - Bioclinical Data Bank

Background LOGGIC Core and LOGGIC Europe are two studies in the UK, which are part of larger European studies addressing questions in children and young adults (up to 21) with paediatric low grade glioma (pLGG). pLGG is the single most common form of brain/spinal cord tumour. They can occur anywhere in the brain and spinal cord, however the tumours can behave very differently.

Some tumours require surgery alone, and others may require many lines of treatment including chemotherapy and radiotherapy. Traditionally pLGG have been treated with chemotherapy as a first line.

As of yet we cannot predict which pLGG will grow, nor can we predict how patients will respond to treatment in both the short and long term.

Most patients (90%) will survive their tumour, however they may do so at a cost to their neurological function and quality of life. All pLGG are thought to be activated by the MAPK pathway, which is normally used to promote growth and development. MEK inhibitors (MEKi) block this pathway, and have shown effectiveness in control of pLGG in small studies.

These small studies in children, in addition to larger studies in adults have shown MEKi to be safe and associated with mild side effects. Aims LOGGIC Core will undertake detailed testing of approximately 500 pLGG in the UK. It will aim to improve diagnostic accuracy and describe groups of pLGG that behave in a similar way.

It will also aim to identify markers in the tumour or child that predict response to treatment.

LOGGIC Europe will aim to identify the best treatment regimen for pLGG with respect to disease control, improvement of neurological behaviour and/or visual function. Methods All consented pLGG patients will have the first level of molecular testing in the UK. This will inform which treatments or clinical trials are appropriate for the patient.

Further detailed testing of the tumour and patient’s blood will be undertaken in Heidelberg (Germany) LOGGIC Europe: All consented patients will be randomised to either vincristine/carboplatin (chemotherapy) or vinblastine (chemotherapy) or trametinib (MEKi). The best treatment will be picked based on disease control, neurological behaviour and vision.

Results: The results of LOGGIC Core will allow us to have a comprehensive understanding of the biology of pLGG, and ways to predict the behaviour of patients and these tumours to treatment. LOGGIC Europe will inform us of the best type of treatment for children with pLGG.