What treatment do you offer to a pediatric patient with an optic pathway glioma with a BRAFV600E mutation who progressed despite receiving conventional chemotherapy, BRAF/MEK inhibitors, and radiation therapy?  

These cases are often tough, especially in this location. I assume the patient does not have NF1?  Most patients with NF1 will not have concurrent specific BRAF mutations. One alternative therapy is a combination of bevacizumab and irinotecan (published by Gururangan et al). Also, if the patien...