INTRODUCTION: Diffuse intrinsic pontine gliomas (DIPG) have a poor prognosis: 
the median survival rate is less than one year. Radiotherapy is the only 
effective treatment affording an overall survival of 6 - 9 months. So far, no 
improvement has been achieved with the addition of single/poly-chemotherapy 
regimens. An urgent need is to advance in this field, from both the biological 
and the clinical points of view.
AREAS COVERED: Among the few studies providing biological information on DIPG, 
Gilbertson's group demonstrated a significant increase in EGFR expression. The 
activity of nimotuzumab, a humanized anti-EGFR monoclonal antibody, was 
therefore studied within a Phase II trial in 47 relapsing pediatric patients 
with DIPG and high-grade gliomas, showing an interesting, persistent response, 
especially in the first group treated. A multicenter exploratory study combining 
nimotuzumab and radiotherapy showed disease control and an overall patient 
survival similar to previous experiences along with an improvement in the 
quality of patient survival and no severe side effects.
EXPERT OPINION: We recommend considering this combination in the armamentarium 
against DIPG. It might be improved by adding other target drugs/low-toxicity 
chemotherapy regimens with a synergistic effect with the anti-EGFR component.