A multi-center, clinical analysis of IDH-mutant gliomas, WHO Grade 4: implications for prognosis and clinical trial design

Mutations in the Isocitrate Dehydrogenase (IDH) genes, IDH1 or IDH2, define a group of adult diffuse gliomas associated with a younger age at diagnosis and better prognosis than IDH wild-type glioblastoma. Within IDH mutant gliomas, a small fraction of astrocytic tumors present with grade 4 histolog...

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Main Authors: Wetzel, Ethan (Author) , Nohman, Amin (Author) , Hsieh, Annie L. (Author) , Reuss, David (Author) , Unterberg, Andreas (Author) , Eyüpoglu, Ilker Yasin (Author) , Hua, Lingyang (Author) , Youssef, Gilbert (Author) , Wen, Patrick Y. (Author) , Cahill, Daniel P. (Author) , Jungk, Christine (Author) , Juratli, Tareq (Author) , Miller, Julie J. (Author)
Format: Article (Journal)
Language:English
Published: 21 October 2024
In: Journal of neuro-oncology
Year: 2025, Volume: 171, Issue: 2, Pages: 373-381
ISSN:1573-7373
DOI:10.1007/s11060-024-04852-7
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1007/s11060-024-04852-7
Verlag, kostenfrei, Volltext: https://link.springer.com/article/10.1007/s11060-024-04852-7
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Author Notes:Ethan A. Wetzel, Amin I. Nohman, Annie L. Hsieh, David Reuss, Andreas W. Unterberg, Ilker Y. Eyüpoglu, Lingyang Hua, Gilbert Youssef, Patrick Y. Wen, Daniel P. Cahill, Christine Jungk, Tareq A. Juratli, Julie J. Miller

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520 |a Mutations in the Isocitrate Dehydrogenase (IDH) genes, IDH1 or IDH2, define a group of adult diffuse gliomas associated with a younger age at diagnosis and better prognosis than IDH wild-type glioblastoma. Within IDH mutant gliomas, a small fraction of astrocytic tumors present with grade 4 histologic features and poor prognosis. In molecular studies, homozygous deletion of CDKN2A/B is independently predictive of poor prognosis and short survival. As a consequence, 2021 WHO classification now also recognizes this molecular feature, CDKN2A/B deletion, as sufficient for classifying an astrocytoma as IDH-mutant, WHO Grade 4, regardless of histological grading. Here, we investigate outcomes of patients with WHO Grade 4 IDH-mutant astrocytoma both with and without CDKN2A/B deletion, to compare these groups and evaluate clinical and radiographic factors that contribute to survival. 
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