Molecular markers in low-grade gliomas: predictive or prognostic?

Purpose: To investigate whether TP53 mutation, 1p/19q codeletions, O6-methylguanylmethyltransferase (MGMT) promoter methylation, and isocitrate dehydrogenase 1 (IDH1) mutation predict natural course of disease or response to radiotherapy or chemotherapy or both in low-grade glioma patients.Experimen...

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Main Authors: Hartmann, Christian (Author) , Hentschel, Bettina (Author) , Tatagiba, Marcos (Author) , Schramm, Johannes (Author) , Schnell, Oliver (Author) , Seidel, Clemens (Author) , Stein, Robert (Author) , Reifenberger, Guido (Author) , Pietsch, Torsten (Author) , Deimling, Andreas von (Author) , Loeffler, Markus (Author) , Weller, Michael (Author)
Format: Article (Journal)
Language:English
Published: 1 July 2011
In: Clinical cancer research
Year: 2011, Volume: 17, Issue: 13, Pages: 4588-4599
ISSN:1557-3265
DOI:10.1158/1078-0432.CCR-10-3194
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1158/1078-0432.CCR-10-3194
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Author Notes:Christian Hartmann, Bettina Hentschel, Marcos Tatagiba, Johannes Schramm, Oliver Schnell, Clemens Seidel, Robert Stein, Guido Reifenberger, Torsten Pietsch, Andreas von Deimling, Markus Loeffler, and Michael Weller, for the German Glioma Network
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Summary:Purpose: To investigate whether TP53 mutation, 1p/19q codeletions, O6-methylguanylmethyltransferase (MGMT) promoter methylation, and isocitrate dehydrogenase 1 (IDH1) mutation predict natural course of disease or response to radiotherapy or chemotherapy or both in low-grade glioma patients.Experimental Design: Cohort A consisted of 89 patients with diffuse astrocytoma World Health Organization (WHO) grade II (n = 40), oligoastrocytoma (n = 23), or oligodendroglioma (n = 26) who did not receive radiotherapy or chemotherapy after first operation and were monitored until progression [progressive disease (PD); n = 59] and beyond or until the end of follow-up (n = 30). Cohort B consisted of 50 patients with WHO grade II gliomas who received radiotherapy or chemotherapy at diagnosis. Tumors were analyzed for TP53 mutations, 1p/19q codeletions, MGMT promoter methylation, and IDH1 mutations.Results: Median progression-free survival (PFS) in cohort A was 4.1 years (95% CI: 3.1-5.1). No molecular marker was prognostic for PFS after surgery alone, using multivariate adjustment for histology, age, and extent of resection. IDH1 mutations were associated with prolonged survival from the diagnosis of PD in oligoastrocytomas (OA II)/oligodendrogliomas (O II) and with overall survival (OS) in all tumors. 1p/19q codeletion and IDH1 mutation were prognostic for PFS and OS in cohort B.Conclusions: None of the parameters are sensitive prognostic biomarkers in WHO grade II glioma patients who do not receive radiotherapy or chemotherapy after surgery. Limitations of this study include the selection of patients with favorable outcome, the nonrandomized allocation of treatment, and the insufficient sample size to distinguish between effects of radiotherapy versus chemotherapy. Regardless of histology, IDH1 mutation status is the strongest prognostic marker for OS. Clin Cancer Res; 17(13); 4588-99. ©2011 AACR.
Item Description:Gesehen am 08.07.2022
Physical Description:Online Resource
ISSN:1557-3265
DOI:10.1158/1078-0432.CCR-10-3194