Promising efficacy of teniposide in H3K27M mutant diffuse midline gliomas: a case report

Diffuse midline glioma with H3K27M mutation (H3K27M-mutant DMG) is a rare central nervous system tumor with an extremely poor prognosis. The absence of a standard treatment regimen makes achieving durable survival benefits a major therapeutic challenge. This study reports the case of a 17-year-old male diagnosed with H3K27M-mutant glioma. Following surgical resection and postoperative concurrent chemoradiotherapy, the patient received adjuvant therapy combining teniposide (VM-26) and bevacizumab, which led to significant radiological and symptomatic improvement. By examining the efficacy of this individualized comprehensive strategy-integrating surgery, chemoradiotherapy, and targeted therapy with teniposide-we assess its potential mechanisms and clinical value. This case suggests a potentially effective treatment option for patients with H3K27M-mutant DMG.