Molecular profile of long-term survivors of glioblastoma: A scoping review of the literature

Gately, Lucy; McLachlan, Sue‐Anne; Philip, Jennifer; Rathi, Vivek; Dowling, Anthony

doi:10.1016/j.jocn.2019.08.017

Cited by 29 publications

(20 citation statements)

References 41 publications

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“…We systematically compared the clinical, radiological, and molecular features between STS and LTS. Although the characteristics of LTS in GBM have been widely investigated ( 5 , 6 , 8 , 9 , 18 , 21 , 22 ), there is no study devoted to exploring the intrinsic properties of IDH-wt and IDH-mut LTS. To our knowledge, it’s the first study that was aimed to disclose the differential predictors and clinical implications between IDH-wt and IDH-mut LTS.…”

Section: Discussionmentioning

confidence: 99%

Differential Predictors and Clinical Implications Associated With Long-Term Survivors in IDH Wildtype and Mutant Glioblastoma

Jiang

Cui

et al. 2021

Front. Oncol.

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BackgroundGlioblastoma (GBM) is the most aggressive intracranial tumor which can be divided into two subtypes based on status of isocitrate dehydrogenase (IDH). A small fraction of patients after receiving standard treatment can be long-term survivors (LTS). This study was designed to disclose the predictors and clinical implications associated with LTS in IDH wildtype and mutant GBM.MethodsPatients who survived beyond five years after diagnosis of GBM were defined as LTS, while those with a survival less than one year were defined as short-term survivors (STS). A total of 211 patients with diagnosis of GBM in Beijing Tiantan Hospital from January 2007 to January 2015 were enrolled, including 44 (20.9%) LTS and 167 (79.1%) STS. The clinical, radiological and molecular features between groups were systematically compared.ResultsCompared with STS, LTS were a subgroup of patients with a younger age at diagnosis (P=0.006), a higher KPS score (P=0.011), higher rates of cystic change (P=0.037), O6-methylguanine-DNA methyltransferase (MGMT) promoter methylation (P=0.007), and IDH mutation (P=0.049), and more likely to have undergone gross total resection (P<0.001). Survival analysis demonstrated that LTS with wildtype IDH conferred a longer progression-free survival (66.0 vs. 27.0 months, P=0.04), but a shorter post-progression survival (46.5 months vs. not reached, P=0.0001) than those of LTS with mutant IDH. LTS with mutant IDH showed a trend towards increased survival after receiving re-operation (P=0.155) and reirradiation (P=0.127), while this clinical benefit disappeared in the subset of LTS with wildtype IDH (P>0.05).ConclusionThe prognostic value and therapeutic implications associated with LTS in GBM population significantly differed on the basis of IDH status. Our findings provide a new approach for physicians to better understand the two subtypes of GBM, which may assist in making more tailored treatment decisions for patients.

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Section: Discussionmentioning

confidence: 99%

Differential Predictors and Clinical Implications Associated With Long-Term Survivors in IDH Wildtype and Mutant Glioblastoma

Jiang

Cui

et al. 2021

Front. Oncol.

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“…MGMT promoter methylation status is an important predictive marker in terms of response to alkylating chemotherapeutic agents, specifically in IDH-wildtype GBM. The value of this in IDH-mutant GBM is less certain, although many studies demonstrate that MGMT promoter methylation is equally important in these tumors [ 122 , 123 , 143 , 144 , 145 , 146 , 147 , 148 , 149 ], and this beneficial effect of MGMT promoter methylation may in part depend on the presence of TERT p mutation [ 144 , 148 , 149 ]. MGMT is a DNA-repair protein whose expression levels inversely correlate with promoter methylation.…”

Section: Idh-wildtype Glioblastomamentioning

confidence: 99%

Beyond IDH-Mutation: Emerging Molecular Diagnostic and Prognostic Features in Adult Diffuse Gliomas

Mirchia

Richardson

2020

Cancers

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Diffuse gliomas are among the most common adult central nervous system tumors with an annual incidence of more than 16,000 cases in the United States. Until very recently, the diagnosis of these tumors was based solely on morphologic features, however, with the publication of the WHO Classification of Tumours of the Central Nervous System, revised 4th edition in 2016, certain molecular features are now included in the official diagnostic and grading system. One of the most significant of these changes has been the division of adult astrocytomas into IDH-wildtype and IDH-mutant categories in addition to histologic grade as part of the main-line diagnosis, although a great deal of heterogeneity in the clinical outcome still remains to be explained within these categories. Since then, numerous groups have been working to identify additional biomarkers and prognostic factors in diffuse gliomas to help further stratify these tumors in hopes of producing a more complete grading system, as well as understanding the underlying biology that results in differing outcomes. The field of neuro-oncology is currently in the midst of a “molecular revolution” in which increasing emphasis is being placed on genetic and epigenetic features driving current diagnostic, prognostic, and predictive considerations. In this review, we focus on recent advances in adult diffuse glioma biomarkers and prognostic factors and summarize the state of the field.

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“…In 2016, the World Health Organization (WHO) revised its criteria for glioblastoma classification, dividing it into primary and secondary subtypes, with primary glioblastoma comprising IDH-wild type tumors and accounting for 90% of all diagnosed and secondary glioblastoma comprising IDH-mutant tumors and accounting for the remaining 10%. This classification system was supported by three separate meta-analyses suggesting improved survival for IDH-mutant tumors, reporting pooled hazard ratios of 0.322 for progression free survival and 0.358 for overall survival (8). This was further supported by a multivariate analysis of 585 glioblastoma patients, which revealed that IDH 1/2 was an independent prognostic marker, with IDH-wildtype having a greater than 4-fold worse outcome compared with IDH-mutant tumor (9).…”

Section: Idh Mutationsmentioning

confidence: 87%

A view of the epidemiologic landscape: how population-based studies can lend novel insights regarding the pathophysiology of glioblastoma

Tadipatri¹,

Lyon

Azadi³

et al. 2021

Chin Clin Oncol

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BackgroundGlioblastoma occurs with a global incidence of between 0.59 and 3.69 per 100,000 people. It accounts for more than 60% of all brain tumors in adults. Despite the rarity of the tumor, it accounts for 2.5% of all cancer-related deaths given its poor prognosis, with a median overall survival rate of 14-15 months after diagnosis with the Stupp regimen, 20.9 months after diagnosis with the addition of tumor treating fields as per the EF-14 trial, or 3 months after diagnosis when left untreated. Although it can occur at any age, the peak incidence is between 75 and 84 years of age with a median age of 64 at diagnosis. Whites have the highest incidence of glioblastoma compared with other ethnicities, and there is a higher incidence among non-Hispanics compared with Hispanics (1-3).Studies have found that survival rates decrease with increasing age, with one review of 139 glioblastoma patients showing a median overall survival of 12 months for patients under 65 years of age and 8 months for patients over 65 years of age (P=0.008) (4,5). Higher functional status was also correlated with improved survival, with a median overall survival of 10 months for patients who had Karnofsky performance status (KPS) greater than 70 and 6 months for patients who had KPS less than 70 (P=0.015), although Cox regression did not show that this was an independent factor. Patients who had a gross total resection had a median

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Molecular profile of long-term survivors of glioblastoma: A scoping review of the literature

Cited by 29 publications

References 41 publications

Differential Predictors and Clinical Implications Associated With Long-Term Survivors in IDH Wildtype and Mutant Glioblastoma

Differential Predictors and Clinical Implications Associated With Long-Term Survivors in IDH Wildtype and Mutant Glioblastoma

Beyond IDH-Mutation: Emerging Molecular Diagnostic and Prognostic Features in Adult Diffuse Gliomas

A view of the epidemiologic landscape: how population-based studies can lend novel insights regarding the pathophysiology of glioblastoma

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