1
|
Muhammad N, Fasih S, Malik B, Hameed S, Loya A, Rashid MU. Predominance of MGMT promoter methylation among Pakistani glioblastoma patients. Mol Biol Rep 2024; 51:433. [PMID: 38520591 DOI: 10.1007/s11033-024-09363-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 02/16/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND Glioblastoma multiforme (GBM), the most prevalent subgroup of neuroepithelial tumors, is characterized by dismal overall survival (OS). Several studies have linked O6-methylguanine-DNA-methyltransferase (MGMT) promoter methylation to OS in GBM patients. However, MGMT methylation frequencies vary geographically and across ethnicities, with limited data for South Asian populations, including Pakistan. This study aimed to analyze MGMT promoter methylation in Pakistani GBM patients. METHODS Consecutive primary GBM patients diagnosed ≥ 18 years-of-age, with no prior chemotherapy or radiotherapy history, were retrospectively selected. DNA was isolated from formalin-fixed-paraffin-embedded tissues. MGMT promoter methylation was analyzed using methylation-specific PCR. Clinical, pathological, and treatment data were assessed using Fisher's exact/Chi-squared tests. OS was calculated using Kaplan-Meier analysis in SPSS 27.0.1. RESULTS The study included 48 GBM patients, comprising 38 (79.2%) males and 10 (20.8%) females. The median diagnosis age was 49.5 years (range 18-70). MGMT methylation was observed in 87.5% (42/48) of all cases. Patients with MGMT methylation undergoing radiotherapy or radiotherapy plus chemotherapy exhibited significantly improved median OS of 7.2 months (95% CI, 3.7-10.7; P < 0.001) and 16.9 months (95% CI, 15.9-17.9; P < 0.001), respectively, compared to those undergoing surgical resection only (OS: 2.2 months, 95% CI, 0.8-3.6). CONCLUSION This is the first comprehensive study highlighting a predominance of MGMT methylation in Pakistani GBM patients. Furthermore, our findings underscore the association of MGMT methylation with improved OS across diverse treatment modalities. Larger studies are imperative to validate our findings for better management of Pakistani GBM patients.
Collapse
Affiliation(s)
- Noor Muhammad
- Basic Sciences Research, Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH&RC), Lahore, Pakistan
| | - Samir Fasih
- Department of Medical Oncology, SKMCH&RC, Lahore, Pakistan
| | - Bilal Malik
- Basic Sciences Research, Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH&RC), Lahore, Pakistan
| | - Shahid Hameed
- Department of Radiation Oncology, SKMCH&RC, Lahore, Pakistan
| | - Asif Loya
- Department of Pathology, SKMCH&RC, Lahore, Pakistan
| | - Muhammad Usman Rashid
- Basic Sciences Research, Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH&RC), Lahore, Pakistan.
| |
Collapse
|
2
|
Chehade G, Lawson TM, Lelotte J, Daoud L, Di Perri D, Whenham N, Duprez T, Tajeddine N, Tissir F, Raftopoulos C. Long-term survival in patients with IDH-wildtype glioblastoma: clinical and molecular characteristics. Acta Neurochir (Wien) 2023; 165:1075-1085. [PMID: 36920664 DOI: 10.1007/s00701-023-05544-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 03/01/2023] [Indexed: 03/16/2023]
Abstract
BACKG ROUND Glioblastoma is an aggressive tumor that has a dismal prognosis even with multimodal treatment. However, some patients survive longer than expected. The objective of this study was to revisit patients diagnosed with glioblastoma according to the 2021 WHO classification and analyze clinical and molecular characteristics associated with long-term survival (LTS). METHODS We retrospectively analyzed 120 IDH-wildtype glioblastomas operated on at our institution between 2013 and 2018. We divided them into LTS patients, surviving more than 3 years, and non-LTS patients, and then compared their features. Additionally, we performed DNA methylation-based brain tumor classification in LTS patients. RESULTS Sixteen patients were long-term survivors. Age < 70 years, MGMT promoter methylation, extent of resection ≥ 95%, and administration of radiochemotherapy were associated with LTS (P = 0.005, P < 0.001, P = 0.048, and P = 0.008, respectively). In addition, when these factors were combined, the probability of LTS was 74% (95% CI: 62--84). The methylome analysis confirmed the diagnosis of glioblastoma in the majority of the tested LTS patients. Regarding subtypes, 29% of cases were mesenchymal (MES), 43% were RTK1, and 29% were RTK2. Interestingly, RTK1 and RTK2 cases tended to have longer overall survival than MES cases (P = 0.057). Moreover, the only tested LTS patient with an unmethylated MGMT promoter had an "adult-type diffuse high-grade glioma, IDH-wildtype, subtype E" rather than a glioblastoma. This tumor was characterized by multinucleated giant cells and a somatic mutation in POLE. CONCLUSIONS We suggest that glioblastoma patients with a combination of favorable prognostic factors can achieve LTS in 74% of cases. In addition, methylome analysis is important to ascertain the type of glioma in LTS patients, especially when the MGMT promoter is unmethylated.
Collapse
Affiliation(s)
- Georges Chehade
- Department of Neurosurgery, Saint-Luc University Hospital, Université Catholique de Louvain, 10 Hippocrate Av, 1St Floor, Woluwe-Saint-Lambert, 1200, Brussels, Belgium.,Developmental Neurobiology, Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
| | - Tévi Morel Lawson
- Department of Neurosurgery, Saint-Luc University Hospital, Université Catholique de Louvain, 10 Hippocrate Av, 1St Floor, Woluwe-Saint-Lambert, 1200, Brussels, Belgium
| | - Julie Lelotte
- Department of Neuropathology, Saint-Luc University Hospital, Université Catholique de Louvain, Brussels, Belgium.,Department of Neuropathology, Institut de Pathologie et de Génétique, Charleroi, Belgium
| | - Lina Daoud
- Department of Neuropathology, Saint-Luc University Hospital, Université Catholique de Louvain, Brussels, Belgium
| | - Dario Di Perri
- Department of Radiotherapy, Saint-Luc University Hospital, Université Catholique de Louvain, Brussels, Belgium
| | - Nicolas Whenham
- Department of Oncology, Saint-Luc University Hospital, Université Catholique de Louvain, Brussels, Belgium
| | - Thierry Duprez
- Department of Radiology, Saint-Luc University Hospital, Université Catholique de Louvain, Brussels, Belgium
| | - Nicolas Tajeddine
- Cell Physiology, Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
| | - Fadel Tissir
- Developmental Neurobiology, Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium.,College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
| | - Christian Raftopoulos
- Department of Neurosurgery, Saint-Luc University Hospital, Université Catholique de Louvain, 10 Hippocrate Av, 1St Floor, Woluwe-Saint-Lambert, 1200, Brussels, Belgium.
| |
Collapse
|
3
|
González Bonet LG, Piqueras-Sánchez C, Roselló-Sastre E, Broseta-Torres R, de las Peñas R. Glioblastomas de larga supervivencia: un análisis sistemático de la literatura a propósito de un caso. Neurocirugia (Astur) 2022. [DOI: 10.1016/j.neucir.2021.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
4
|
González Bonet LG, Piqueras-Sánchez C, Roselló-Sastre E, Broseta-Torres R, de Las Peñas R. Long-term survival of glioblastoma: A systematic analysis of literature about a case. NEUROCIRUGIA (ENGLISH EDITION) 2022; 33:227-236. [PMID: 34802981 DOI: 10.1016/j.neucie.2021.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 05/05/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION In spite of the changes for the treatment of glioblastoma since 2005, we have not seen differences between long-survival patients of more than 10 years showing a value minor than 1%. MATERIAL AND METHOD We realize a systematic analysis and identify important factors for long survivor patients. We also show an own case with more of 20 years of survival. We make a new pathological study of the old paraffin block of this patient. RESULTS The most important variable associated with long-survival between all multivariant studies is the age. When we try to find genetic and molecular alterations in glioblastoma associated with prolongated survival, the MGMT promoter methylation play the most important role. We find a correct diagnosis in the current analysis of our patient's sample with very long survival. CONCLUSIONS Multiple variables are found that affect long survival of glioblastoma series but analyzed studies are very heterogeneous and it is very difficult comparation between them. Most articles we review are obtained from databases of different countries with hundreds of patients. It would be very interesting to promote the use of a single database in Spain that allows us to study these long-term glioblastoma survivors.
Collapse
Affiliation(s)
- Luis Germán González Bonet
- Servicio de Neurocirugía, Hospital General Universitario de Castellón, Castellón, Spain; Facultad de Ciencias de la Salud, Universidad Jaume I de Castellón, Castellón, Spain.
| | | | - Esther Roselló-Sastre
- Facultad de Ciencias de la Salud, Universidad Jaume I de Castellón, Castellón, Spain; Servicio de Anatomía Patológica, Hospital General Universitario de Castellón, Castellón, Spain
| | | | - Ramón de Las Peñas
- Servicio de Oncología Médica, Hospital Provincial de Castellón, Castellón, Spain
| |
Collapse
|
5
|
Probing individual-level structural atrophy in frontal glioma patients. Neurosurg Rev 2022; 45:2845-2855. [PMID: 35508819 DOI: 10.1007/s10143-022-01800-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 04/15/2022] [Accepted: 04/25/2022] [Indexed: 10/18/2022]
Abstract
Although every glioma patient varies in tumor size, location, histological grade and molecular biomarkers, non-tumoral morphological abnormalities are commonly detected by a statistical comparison among patient groups, missing the information of individual morphological alterations. In this study, we introduced an individual-level structural abnormality detection method for glioma patients and proposed several abnormality indexes to depict individual atrophy patterns. Forty-five patients with a glioma in the frontal lobe and fifty-one age-matched healthy controls participated in the study. Individual structural abnormality maps (SAM) were generated using patients' preoperative T1 images, by calculating the degree of deviation of voxel volume in each patient with the normative model built from healthy controls. Based on SAM, a series of individual abnormality indexes were computed, and their relationship with glioma characteristics was explored. The results demonstrated that glioma patients showed unique non-tumoral atrophy patterns with overlapping atrophy regions mainly located at hippocampus, parahippocampus, amygdala, insula, middle temporal gyrus and inferior temporal gyrus, which are closely related to the human cognitive functions. The abnormality indexes were associated with several molecular biomarkers including isocitrate dehydrogenase (IDH) mutation, 1p/19q co-deletion and telomerase reverse transcriptase (TERT) promoter mutation. Our study provides an effective way to access the individual-level non-tumoral structural abnormalities in glioma patients, which has the potential to significantly improve individualized precision medicine.
Collapse
|
6
|
Jiang H, Yu K, Cui Y, Ren X, Li M, Zhang G, Yang C, Zhao X, Zhu Q, Lin S. Differential Predictors and Clinical Implications Associated With Long-Term Survivors in IDH Wildtype and Mutant Glioblastoma. Front Oncol 2021; 11:632663. [PMID: 34055603 PMCID: PMC8155513 DOI: 10.3389/fonc.2021.632663] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 04/26/2021] [Indexed: 11/16/2022] Open
Abstract
Background Glioblastoma (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. Methods Patients 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. Results Compared 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). Conclusion The 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.
Collapse
Affiliation(s)
- Haihui Jiang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,National Clinical Research Center for Neurological Diseases, Center of Brain Tumor, Beijing Institute for Brain Disorders and Beijing Key Laboratory of Brain Tumor, Beijing, China
| | - Kefu Yu
- Department of Pharmacy, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yong Cui
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,National Clinical Research Center for Neurological Diseases, Center of Brain Tumor, Beijing Institute for Brain Disorders and Beijing Key Laboratory of Brain Tumor, Beijing, China
| | - Xiaohui Ren
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,National Clinical Research Center for Neurological Diseases, Center of Brain Tumor, Beijing Institute for Brain Disorders and Beijing Key Laboratory of Brain Tumor, Beijing, China
| | - Mingxiao Li
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,National Clinical Research Center for Neurological Diseases, Center of Brain Tumor, Beijing Institute for Brain Disorders and Beijing Key Laboratory of Brain Tumor, Beijing, China
| | - Guobin Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,National Clinical Research Center for Neurological Diseases, Center of Brain Tumor, Beijing Institute for Brain Disorders and Beijing Key Laboratory of Brain Tumor, Beijing, China
| | - Chuanwei Yang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,National Clinical Research Center for Neurological Diseases, Center of Brain Tumor, Beijing Institute for Brain Disorders and Beijing Key Laboratory of Brain Tumor, Beijing, China
| | - Xuzhe Zhao
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,National Clinical Research Center for Neurological Diseases, Center of Brain Tumor, Beijing Institute for Brain Disorders and Beijing Key Laboratory of Brain Tumor, Beijing, China
| | - Qinghui Zhu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,National Clinical Research Center for Neurological Diseases, Center of Brain Tumor, Beijing Institute for Brain Disorders and Beijing Key Laboratory of Brain Tumor, Beijing, China
| | - Song Lin
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,National Clinical Research Center for Neurological Diseases, Center of Brain Tumor, Beijing Institute for Brain Disorders and Beijing Key Laboratory of Brain Tumor, Beijing, China.,Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| |
Collapse
|
7
|
Richardson TE, Kumar A, Xing C, Hatanpaa KJ, Walker JM. Overcoming the Odds: Toward a Molecular Profile of Long-Term Survival in Glioblastoma. J Neuropathol Exp Neurol 2021; 79:1031-1037. [PMID: 32954439 DOI: 10.1093/jnen/nlaa102] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
For over a century, gliomas were characterized solely by histologic features. With the publication of the WHO Classification of Tumours of the Central Nervous System, Revised 4th Edition in 2016, integrated histologic and molecular diagnosis became the norm, providing improved tumor grading and prognosis with IDH1/2 (isocitrate dehydrogenase 1 and 2) mutation being the most significant prognostic feature in all grades of adult diffuse glioma. Since then, much work has been done to identify additional molecular prognostic features, but the bulk of the progress has been made in defining aggressive features in lower grade astrocytoma. Although there have been several large case series of glioblastomas with long-term survival (LTS; overall survival ≥36 months), less is known about the clinical and molecular features of these cases. Herein, we review 19 studies examining LTS glioblastoma patients from 2009 to 2020 that include variable molecular analysis, including 465 cases with survival of 36 months or more (total n = 2328). These studies suggest that while there is no definitive molecular signature of long survival, younger age, IDH mutation, and MGMT (methyl guanine methyl transferase) promoter hypermethylation are associated with longer overall survival, and in IDH-wildtype tumors, chromosome 19/20 co-gain and lack of EGFR amplification, chromosome 7 gain/10 loss, and TERT promoter mutation are associated with LTS.
Collapse
Affiliation(s)
- Timothy E Richardson
- Department of Pathology, State University of New York, Upstate Medical University, Syracuse, New York
| | - Ashwani Kumar
- Eugene McDermott Center for Human Growth & Development
| | - Chao Xing
- Eugene McDermott Center for Human Growth & Development.,Department of Bioinformatics and Department of Population and Data Sciences
| | | | - Jamie M Walker
- University of Texas Southwestern Medical Center, Dallas, Texas; and Department of Pathology and Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, University of Texas Health Science Center, San Antonio, Texas
| |
Collapse
|
8
|
The distribution of isocitrate dehydrogenase mutations, O6-methylguanine-DNA methyltransferase promoter methylation, and 1p/19q codeletion in different glioma subtypes and their correlation with glioma prognosis in Taiwanese population: A single center study. INTERDISCIPLINARY NEUROSURGERY 2021. [DOI: 10.1016/j.inat.2020.100922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
|
9
|
Jiang H, Yu K, Li M, Cui Y, Ren X, Yang C, Zhao X, Lin S. Classification of Progression Patterns in Glioblastoma: Analysis of Predictive Factors and Clinical Implications. Front Oncol 2020; 10:590648. [PMID: 33251147 PMCID: PMC7673412 DOI: 10.3389/fonc.2020.590648] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Accepted: 10/12/2020] [Indexed: 12/16/2022] Open
Abstract
Background This study was designed to explore the progression patterns of IDH-wildtype glioblastoma (GBM) at first recurrence after chemoradiotherapy. Methods Records from 247 patients who underwent progression after diagnosis of IDH-wildtype GBM was retrospectively reviewed. Progression patterns were classified as either local, distant, subependymal or leptomeningeal dissemination based on the preoperative and serial postoperative radiographic images. The clinical and molecular characteristics of different progression patterns were analyzed. Results A total of 186 (75.3%) patients had local progression, 15 (6.1%) patients had distant progression, 33 (13.3%) patients had subependymal dissemination, and 13 (5.3%) patients had leptomeningeal dissemination. The most favorable survival occurred in patients with local progression, while no significant difference of survival was found among patients with distant progression, subependymal or leptomeningeal dissemination who were thereby reclassified into non-local group. Multivariable analysis showed that chemotherapy was a protective factor for non-local progression, while gender of male, subventricular zone (SVZ) involvement and O6-methylguanine-DNA-methyltransferase (MGMT) promoter methylation were confirmed as risk factors for non-local progression (P < 0.05). Based on the factors screened by multivariable analysis, a nomogram was constructed which conferred high accuracy in predicting non-local progression. Patients in non-local group could be divided into long- and short-term survivors who differed in the rates of SVZ involvement, MGMT promoter methylation and reirradiation (P < 0.05), and a nomogram integrating these factors showed high accuracy in predicting long-term survivors. Conclusion Patients harboring different progression patterns conferred distinct clinical and molecular characteristics. Our nomograms could provide theoretical references for physicians to make more personalized and precise treatment decisions.
Collapse
Affiliation(s)
- Haihui Jiang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,National Clinical Research Center for Neurological Diseases, Center of Brain Tumor, Beijing Institute for Brain Disorders and Beijing Key Laboratory of Brain Tumor, Beijing, China
| | - Kefu Yu
- Department of Pharmacy, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Mingxiao Li
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,National Clinical Research Center for Neurological Diseases, Center of Brain Tumor, Beijing Institute for Brain Disorders and Beijing Key Laboratory of Brain Tumor, Beijing, China
| | - Yong Cui
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,National Clinical Research Center for Neurological Diseases, Center of Brain Tumor, Beijing Institute for Brain Disorders and Beijing Key Laboratory of Brain Tumor, Beijing, China
| | - Xiaohui Ren
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,National Clinical Research Center for Neurological Diseases, Center of Brain Tumor, Beijing Institute for Brain Disorders and Beijing Key Laboratory of Brain Tumor, Beijing, China
| | - Chuanwei Yang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,National Clinical Research Center for Neurological Diseases, Center of Brain Tumor, Beijing Institute for Brain Disorders and Beijing Key Laboratory of Brain Tumor, Beijing, China
| | - Xuzhe Zhao
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,National Clinical Research Center for Neurological Diseases, Center of Brain Tumor, Beijing Institute for Brain Disorders and Beijing Key Laboratory of Brain Tumor, Beijing, China
| | - Song Lin
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,National Clinical Research Center for Neurological Diseases, Center of Brain Tumor, Beijing Institute for Brain Disorders and Beijing Key Laboratory of Brain Tumor, Beijing, China
| |
Collapse
|
10
|
Improved 3-year survival rates for glioblastoma multiforme are associated with trends in treatment: analysis of the national cancer database from 2004 to 2013. J Neurooncol 2020; 148:69-79. [DOI: 10.1007/s11060-020-03469-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 03/23/2020] [Indexed: 12/22/2022]
|
11
|
Alan O, Telli TA, Tuylu TB, Arikan R, Demircan NC, Ercelep O, Kaya S, Babacan NA, Atasoy BM, Bozkurt S, Bayri Y, Gul D, Ekinci G, Ziyal I, Dane F, Yumuk PF. Prognostic factors in progressive high-grade glial tumors treated with systemic approach: A single center experience. J Oncol Pharm Pract 2020; 27:329-339. [PMID: 32349641 DOI: 10.1177/1078155220920684] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE Malignant high-grade gliomas are the most common and aggressive type of primary brain tumor, and the prognosis is generally extremely poor. In this retrospective study, we analyzed the outcome of systemic treatment in recurrent high-grade glioma patients and the impact of prognostic factors on survivals. METHODS Data from 114 patients with recurrent high-grade glioma who received systemic treatment and followed in our clinic between 2012 and 2018 were retrospectively analyzed. Eastern Cooperative Oncology Group (ECOG) performance status, age, gender, histology, type of surgical resection, side effects after systemic treatment (deep vein thrombosis, hypertension, proteinuria), IDH1 and alpha thalassemia/mental retardation syndrome X-linked (ATRX) mutation status were investigated as prognostic factors for progression-free survival and overall survival. RESULTS At the time of diagnosis, the median age was 48 (17-77) and 68% of the patients were male. Most common pathologic subtype was glioblastoma multiforme (68%). Median follow-up duration was 9.1 months (1-68 months). Median progression-free survival and overall survival were 6.2 months and 8 months, respectively. In multivariate analysis, ECOG PS, deep venous thrombosis and the presence of ATRX and IDH1 mutation were found to be independent prognostic factors for progression-free survival (p < 0.05) and, ECOG PS, the presence of ATRX and IDH1 mutation for overall survival (p < 0.05). CONCLUSION Our study is real life data and the median progression-free survival and overall survival rates are similar to the literature. We have found ECOG PS, presence of ATRX and IDH1 mutation to be independent prognostic factors for both progression-free survival and overall survival.
Collapse
Affiliation(s)
- Ozkan Alan
- Division of Medical Oncology, Department of Internal Medicine, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Tugba Akin Telli
- Division of Medical Oncology, Department of Internal Medicine, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Tugba Basoglu Tuylu
- Division of Medical Oncology, Department of Internal Medicine, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Rukiye Arikan
- Division of Medical Oncology, Department of Internal Medicine, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Nazım Can Demircan
- Division of Medical Oncology, Department of Internal Medicine, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Ozlem Ercelep
- Marmara University Pendik Education and Research Hospital, Medical Oncology Clinic, Istanbul, Turkey
| | - Serap Kaya
- Marmara University Pendik Education and Research Hospital, Medical Oncology Clinic, Istanbul, Turkey
| | - Nalan Akgul Babacan
- Marmara University Pendik Education and Research Hospital, Medical Oncology Clinic, Istanbul, Turkey
| | - Beste M Atasoy
- Department of Radiation Oncology, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Suheyla Bozkurt
- Department of Pathology, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Yasar Bayri
- Department of Neurosurgery, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Dilek Gul
- Marmara University Pendik Education and Research Hospital, Radiation Oncology Clinic, Istanbul, Turkey
| | - Gazanfer Ekinci
- Department of Radiology, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Ibrahim Ziyal
- Department of Neurosurgery, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Faysal Dane
- Division of Medical Oncology, Department of Internal Medicine, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - P Fulden Yumuk
- Division of Medical Oncology, Department of Internal Medicine, Marmara University Faculty of Medicine, Istanbul, Turkey
| |
Collapse
|
12
|
Gately L, McLachlan SA, Philip J, Rathi V, Dowling A. Molecular profile of long-term survivors of glioblastoma: A scoping review of the literature. J Clin Neurosci 2019; 68:1-8. [PMID: 31416731 DOI: 10.1016/j.jocn.2019.08.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 06/17/2019] [Accepted: 08/04/2019] [Indexed: 02/06/2023]
Abstract
Molecular aberrations of malignancy are becoming widely recognized as important predictive and prognostic markers for treatment response and survival in oncology and have been linked to the discovery of novel treatment targets. This area of research in glioblastoma continues to evolve. The aim of this scoping review was to document the hallmark molecular characteristics of long-term survivors of glioblastoma. MEDLINE, Scopus and EMBASE were searched with core concepts: (1) glioblastoma, (2) long-term survivor and (3) molecular OR mutation. A thematic analysis was undertaken of the 18 included studies. Four main classes of characteristics were obtained: IDH mutation, MGMT methylation, other known characteristics and novel discoveries. While MGMT methylation or the combination with IDH mutation are suggested to be hallmark characteristics, there remains enough uncertainty to suggest further factors may be involved, such as CD34 expression. Further research is required to accurately describe hallmark molecular characteristics of long-term survivors to assist in defining these patients at diagnosis, preventing treatment complications and discovering novel treatments.
Collapse
Affiliation(s)
- L Gately
- Department of Medical Oncology, St Vincent's Hospital, Melbourne, Australia.
| | - S A McLachlan
- Department of Medical Oncology, St Vincent's Hospital, Melbourne, Australia
| | - J Philip
- Department of Medicine, University of Melbourne, Australia
| | - V Rathi
- Department of Anatomical Pathology, St Vincent's Hospital, Melbourne, Australia; Department of Pathology, University of Melbourne, Australia
| | - A Dowling
- Department of Medical Oncology, St Vincent's Hospital, Melbourne, Australia
| |
Collapse
|
13
|
Ozturk K, Soylu E, Tolunay S, Narter S, Hakyemez B. Dynamic Contrast-Enhanced T1-Weighted Perfusion Magnetic Resonance Imaging Identifies Glioblastoma Immunohistochemical Biomarkers via Tumoral and Peritumoral Approach: A Pilot Study. World Neurosurg 2019; 128:e195-e208. [PMID: 31003026 DOI: 10.1016/j.wneu.2019.04.089] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 04/08/2019] [Accepted: 04/09/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVE We aimed to evaluate the usefulness of dynamic contrast-enhanced T1-weighted perfusion magnetic resonance imaging (DCE-pMRI) to predict certain immunohistochemical (IHC) biomarkers of glioblastoma (GB) in this pilot study. METHODS We retrospectively reviewed 36 patients (male/female, 25:11; mean age, 53 years; age range, 29-85 years) who had pretreatment DCE-pMRI with IHC analysis of their excised GBs. Regions of interest of the enhancing tumor (ER) and nonenhancing peritumoral region (NER) were used to calculate DCE-pMRI parameters of volume transfer constant, back flux constant, volume of the extravascular extracellular space, initial area under enhancement curve, and maximum slope. IHC biomarkers including Ki-67 labeling index, epidermal growth factor receptor (EGFR), oligodendrocyte transcription factor 2 (OLIG2), isocitrate dehydrogenase 1 (IDH1), and p53 mutation status were determined. The imaging metrics of GB with IHC markers were compared using the Kruskal-Wallis test and Spearman correlation analysis. RESULTS Among 30 patients with available IDH1 status, 14 patients (46.6%) had IDH1 mutation. EGFR amplification was present in 24/36 (66.6%) patients. Mean Ki-67 labeling index was 29% (range, 1.5%-80%). p53 mutation was present in 20/36 GBs (55%), whereas OLIG2 expression was positive in 29/36 GBs (80.5%). Various DCE-pMRI parameters gathered from the ER and NER were significantly correlated with IDH1 mutation, EGFR amplification, and OLIG2 expression (P < 0.05). Ki-67 labeling index showed a strong positive correlation with initial area under enhancement curve (r = 0.619; P < 0.001). CONCLUSIONS DCE-pMRI could determine surrogate IHC biomarkers in GB via tumoral and peritumoral approach, potential targets for individualized treatment protocols.
Collapse
Affiliation(s)
- Kerem Ozturk
- Department of Radiology, Uludag University Faculty of Medicine, Bursa, Turkey
| | - Esra Soylu
- Department of Radiology, Uludag University Faculty of Medicine, Bursa, Turkey
| | - Sahsine Tolunay
- Department of Pathology, Uludag University Faculty of Medicine, Bursa, Turkey
| | - Selin Narter
- Department of Pathology, Uludag University Faculty of Medicine, Bursa, Turkey
| | - Bahattin Hakyemez
- Department of Radiology, Uludag University Faculty of Medicine, Bursa, Turkey.
| |
Collapse
|
14
|
Jiang H, Cui Y, Liu X, Ren X, Li M, Lin S. Proliferation-dominant high-grade astrocytoma: survival benefit associated with extensive resection of FLAIR abnormality region. J Neurosurg 2019; 132:998-1005. [PMID: 30901758 DOI: 10.3171/2018.12.jns182775] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 12/10/2018] [Indexed: 01/30/2023]
Abstract
OBJECTIVE The aim of this study was to investigate the relationship between extent of resection (EOR) and survival in terms of clinical, molecular, and radiological factors in high-grade astrocytoma (HGA). METHODS Clinical and radiological data from 585 cases of molecularly defined HGA were reviewed. In each case, the EOR was evaluated twice: once according to contrast-enhanced T1-weighted images (CE-T1WI) and once according to fluid attenuated inversion recovery (FLAIR) images. The ratio of the volume of the region of abnormality in CE-T1WI to that in FLAIR images (VFLAIR/VCE-T1WI) was calculated and a receiver operating characteristic curve was used to determine the optimal cutoff value for that ratio. Univariate and multivariate analyses were performed to identify the prognostic value of each factor. RESULTS Both the EOR evaluated from CE-T1WI and the EOR evaluated from FLAIR could divide the whole cohort into 4 subgroups with different survival outcomes (p < 0.001). Cases were stratified into 2 subtypes based on VFLAIR/VCE-T1WI with a cutoff of 10: a proliferation-dominant subtype and a diffusion-dominant subtype. Kaplan-Meier analysis showed a significant survival advantage for the proliferation-dominant subtype (p < 0.0001). The prognostic implication has been further confirmed in the Cox proportional hazards model (HR 1.105, 95% CI 1.078-1.134, p < 0.0001). The survival of patients with proliferation-dominant HGA was significantly prolonged in association with extensive resection of the FLAIR abnormality region beyond contrast-enhancing tumor (p = 0.03), while no survival benefit was observed in association with the extensive resection in the diffusion-dominant subtype (p = 0.86). CONCLUSIONS VFLAIR/VCE-T1WI is an important classifier that could divide the HGA into 2 subtypes with distinct invasive features. Patients with proliferation-dominant HGA can benefit from extensive resection of the FLAIR abnormality region, which provides the theoretical basis for a personalized resection strategy.
Collapse
Affiliation(s)
- Haihui Jiang
- 1Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, and China National Clinical Research Center for Neurological Diseases, Center of Brain Tumor, Beijing Institute for Brain Disorders and Beijing Key Laboratory of Brain Tumor, Beijing, China; and
| | - Yong Cui
- 1Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, and China National Clinical Research Center for Neurological Diseases, Center of Brain Tumor, Beijing Institute for Brain Disorders and Beijing Key Laboratory of Brain Tumor, Beijing, China; and
| | - Xiang Liu
- 2Department of Imaging Sciences, University of Rochester Medical Center, Rochester, New York
| | - Xiaohui Ren
- 1Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, and China National Clinical Research Center for Neurological Diseases, Center of Brain Tumor, Beijing Institute for Brain Disorders and Beijing Key Laboratory of Brain Tumor, Beijing, China; and
| | - Mingxiao Li
- 1Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, and China National Clinical Research Center for Neurological Diseases, Center of Brain Tumor, Beijing Institute for Brain Disorders and Beijing Key Laboratory of Brain Tumor, Beijing, China; and
| | - Song Lin
- 1Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, and China National Clinical Research Center for Neurological Diseases, Center of Brain Tumor, Beijing Institute for Brain Disorders and Beijing Key Laboratory of Brain Tumor, Beijing, China; and
| |
Collapse
|
15
|
Yang K, Ren X, Tao L, Wang P, Jiang H, Shen L, Zhao Y, Cui Y, Li M, Lin S. Prognostic implications of epidermal growth factor receptor variant III expression and nuclear translocation in Chinese human gliomas. Chin J Cancer Res 2019; 31:188-202. [PMID: 30996577 PMCID: PMC6433583 DOI: 10.21147/j.issn.1000-9604.2019.01.14] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Objective To determine the prognostic implications and clinical significance of epidermal growth factor receptor variant III (EGFRvIII) expression and EGFRvIII nuclear translocation in Chinese human gliomas. Methods We retrospectively examined EGFRvIII expression and EGFRvIII nuclear translocation using immunohistochemistry in specimens of 240 Chinese patients with glioma, including 84 World Health Organization (WHO) II gliomas, 84 WHO III gliomas and 72 glioblastomas (WHO IV). Factors that correlated with EGFRvIII and EGFRvIII nuclear translocation expression were analyzed by the Chi-square test. Kaplan-Meier methodology and Cox regression were used for the survival analysis. Results Log-rank tests showed that patient age, Karnofsky performance scale (KPS) score, tumor grade, EGFRvIII expression, EGFRvIII nuclear translocation, 1p/19q codeletion, isocitrate dehydrogenase (IDH) mutation, Ki-67 labeling index and O6-methylguanine-DNA methyltransferase (MGMT) status (P<0.05) were significantly correlated with overall survival (OS) time. Multivariate Cox regression analysis revealed that patient age, tumor grade, EGFRvIII nuclear translocation, 1p/19q codeletion, and IDH mutation (P<0.05) were significantly correlated with OS. Patients with a high level of EGFRvIII nuclear translocation (≥7%) had both significantly shorter OS [hazard ratio (HR): 1.920, 95% confidence interval (95% CI): 1.228−3.003, P=0.004] and progression-free survival (PFS) times (HR: 1.661, 95% CI: 1.116−2.471, P=0.012) than those with a low level of EGFRvIII nuclear translocation (<7%). Conclusions A high level of EGFRvIII nuclear translocation in glioma is an independent factor indicating a poor prognosis, but EGFRvIII expression is not an independent clinical prognostic factor. The level of EGFRvIII nuclear translocation maybe a novel and crucial prognostic biomarker in glioma.
Collapse
Affiliation(s)
- Kaiyuan Yang
- Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China.,China National Clinical Research Center for Neurological Diseases, Beijing 100070, China.,Beijing Neurosurgical Institution, Capital Medical University, Beijing 100050, China
| | - Xiaohui Ren
- Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China.,China National Clinical Research Center for Neurological Diseases, Beijing 100070, China.,Beijing Neurosurgical Institution, Capital Medical University, Beijing 100050, China
| | - Liyuan Tao
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing 100191, China
| | - Peipei Wang
- Department of Cell Biology, Peking University Health Science Center, Beijing 100191, China.,Peking University Stem Cell Research Center, Beijing 100191, China
| | - Haihui Jiang
- Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China.,China National Clinical Research Center for Neurological Diseases, Beijing 100070, China.,Beijing Neurosurgical Institution, Capital Medical University, Beijing 100050, China
| | - Li Shen
- Department of Cell Biology, Peking University Health Science Center, Beijing 100191, China.,Peking University Stem Cell Research Center, Beijing 100191, China
| | - Yiming Zhao
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing 100191, China
| | - Yong Cui
- Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China.,China National Clinical Research Center for Neurological Diseases, Beijing 100070, China.,Beijing Neurosurgical Institution, Capital Medical University, Beijing 100050, China
| | - Mingxiao Li
- Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China.,China National Clinical Research Center for Neurological Diseases, Beijing 100070, China.,Beijing Neurosurgical Institution, Capital Medical University, Beijing 100050, China
| | - Song Lin
- Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China.,China National Clinical Research Center for Neurological Diseases, Beijing 100070, China.,Beijing Neurosurgical Institution, Capital Medical University, Beijing 100050, China
| |
Collapse
|
16
|
Young JS, Prados MD, Butowski N. Using genomics to guide treatment for glioblastoma. Pharmacogenomics 2018; 19:1217-1229. [PMID: 30203716 DOI: 10.2217/pgs-2018-0078] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Glioblastoma has been shown to have many different genetic mutations found both within and between tumor samples. Molecular testing and genomic sequencing has helped to classify diagnoses and clarify difficult to interpret histopathological specimens. Genomic information also plays a critical role in prognostication for patients, with IDH mutations and MGMT methylation having significant impact of the response to chemotherapy and overall survival of patients. Unfortunately, personalized medicine and targeted therapy against specific mutations have not been shown to improve patient outcomes. As technology continues to improve, exome and RNA sequencing will play a role in the design of clinical trials, classification of patient subgroups and identification of rare mutations that can be targeted by small-molecule inhibitors and biologic agents.
Collapse
Affiliation(s)
- Jacob S Young
- Department of Neurological Surgery, University of California, San Francisco, CA 94143, USA
| | - Michael D Prados
- Department of Neurological Surgery, University of California, San Francisco, CA 94143, USA
| | - Nicholas Butowski
- Department of Neurological Surgery, University of California, San Francisco, CA 94143, USA
| |
Collapse
|
17
|
Tiram G, Ferber S, Ofek P, Eldar-Boock A, Ben-Shushan D, Yeini E, Krivitsky A, Blatt R, Almog N, Henkin J, Amsalem O, Yavin E, Cohen G, Lazarovici P, Lee JS, Ruppin E, Milyavsky M, Grossman R, Ram Z, Calderón M, Haag R, Satchi-Fainaro R. Reverting the molecular fingerprint of tumor dormancy as a therapeutic strategy for glioblastoma. FASEB J 2018; 32:fj201701568R. [PMID: 29856660 DOI: 10.1096/fj.201701568r] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Glioblastoma is an aggressive and invasive brain malignancy with high mortality rates despite current treatment modalities. In this study, we show that a 7-gene signature, previously found to govern the switch of glioblastomas from dormancy to aggressive tumor growth, correlates with improved overall survival of patients with glioblastoma. Using glioblastoma dormancy models, we validated the role of 2 genes from the signature, thrombospondin-1 ( TSP-1) and epidermal growth factor receptor ( EGFR), as regulators of glioblastoma dormancy and explored their therapeutic potential. EGFR up-regulation was reversed using EGFR small interfering RNA polyplex, antibody, or small-molecule inhibitor. The diminished function of TSP-1 was augmented via a peptidomimetic. The combination of EGFR inhibition and TSP-1 restoration led to enhanced therapeutic efficacy in vitro, in 3-dimensional patient-derived spheroids, and in a subcutaneous human glioblastoma model in vivo. Systemic administration of the combination therapy to mice bearing intracranial murine glioblastoma resulted in marginal therapeutic outcomes, probably due to brain delivery challenges, p53 mutation status, and the aggressive nature of the selected cell line. Nevertheless, this study provides a proof of concept for exploiting regulators of tumor dormancy for glioblastoma therapy. This therapeutic strategy can be exploited for future investigations using a variety of therapeutic entities that manipulate the expression of dormancy-associated genes in glioblastoma as well as in other cancer types.-Tiram, G., Ferber, S., Ofek, P., Eldar-Boock, A., Ben-Shushan, D., Yeini, E., Krivitsky, A., Blatt, R., Almog, N., Henkin, J., Amsalem, O., Yavin, E., Cohen, G., Lazarovici, P., Lee, J. S., Ruppin, E., Milyavsky, M., Grossman, R., Ram, Z., Calderón, M., Haag, R., Satchi-Fainaro, R. Reverting the molecular fingerprint of tumor dormancy as a therapeutic strategy for glioblastoma.
Collapse
Affiliation(s)
- Galia Tiram
- Department of Physiology and Pharmacology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shiran Ferber
- Department of Physiology and Pharmacology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Paula Ofek
- Department of Physiology and Pharmacology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Anat Eldar-Boock
- Department of Physiology and Pharmacology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dikla Ben-Shushan
- Department of Physiology and Pharmacology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Eilam Yeini
- Department of Physiology and Pharmacology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Adva Krivitsky
- Department of Physiology and Pharmacology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Roni Blatt
- Department of Physiology and Pharmacology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Nava Almog
- Center of Cancer Systems Biology, Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Jack Henkin
- Chemistry of Life Processes Institute, Northwestern University, Evanston, Illinois, USA
| | - Orit Amsalem
- School of Pharmacy Institute for Drug Research, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Eylon Yavin
- School of Pharmacy Institute for Drug Research, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Gadi Cohen
- School of Pharmacy Institute for Drug Research, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Philip Lazarovici
- School of Pharmacy Institute for Drug Research, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Joo Sang Lee
- Department of Computer Science, University of Maryland, College Park, Maryland, USA
- Center for Bioinformatics and Computational Biology, University of Maryland, College Park, Maryland, USA
| | - Eytan Ruppin
- Department of Physiology and Pharmacology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Computer Science, University of Maryland, College Park, Maryland, USA
- Center for Bioinformatics and Computational Biology, University of Maryland, College Park, Maryland, USA
- Blavatnik School of Computer Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Michael Milyavsky
- Department of Pathology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Rachel Grossman
- Department of Neurosurgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Zvi Ram
- Department of Neurosurgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Marcelo Calderón
- Institut für Chemie und Biochemie, Freie Universität Berlin, Berlin, Germany
| | - Rainer Haag
- Institut für Chemie und Biochemie, Freie Universität Berlin, Berlin, Germany
| | - Ronit Satchi-Fainaro
- Department of Physiology and Pharmacology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Sagol School of Neurosciences, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
18
|
Molecular profiling of short-term and long-term surviving patients identifies CD34 mRNA level as prognostic for glioblastoma survival. J Neurooncol 2018; 137:533-542. [DOI: 10.1007/s11060-017-2739-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Accepted: 12/29/2017] [Indexed: 12/17/2022]
|
19
|
A combined diffusion tensor imaging and Ki-67 labeling index study for evaluating the extent of tumor infiltration using the F98 rat glioma model. J Neurooncol 2018; 137:259-268. [PMID: 29294232 DOI: 10.1007/s11060-017-2734-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 12/26/2017] [Indexed: 10/18/2022]
Abstract
Diffusion tensor imaging (DTI) has been proven to be a sophisticated and useful tool for the delineation of tumors. In the present study, we investigated the predictive role of DTI compared to other magnetic resonance imaging (MRI) techniques in combination with Ki-67 labeling index in defining tumor cell infiltration in the peritumoral regions of F98 glioma-bearing rats. A total of 29 tumor-bearing Fischer rats underwent T2-weighted imaging, contrast-enhanced T1-weighted imaging, and DTI of their brain using a 7.0-T MRI scanner. The fractional anisotropy (FA) ratios were correlated to the Ki-67 labeling index using the Spearman correlation analysis. A receiver operating characteristic curve (ROC) analysis was established to evaluate parameters with sensitivity and specificity in order to identify the threshold values for predicting tumor infiltration. Significant correlations were observed between the FA ratios and Ki-67 labeling index (r = - 0.865, p < 0.001). The ROC analysis demonstrated that the apparent diffusion coefficient (ADC) and FA ratios could predict 50% of the proliferating cells in the regions of interest (ROI), with a sensitivity of 88.1 and 81.3%, and a specificity of 86.2 and 90.2%, respectively (p < 0.001). Meanwhile, the two ratios could also predict 10% of the proliferating cells in the ROI, with a sensitivity of 82.5 and 94.9%, and a specificity of 100 and 88.9%, respectively (p < 0.001). The present study demonstrated that the FA ratios are closely correlated with the Ki-67 labeling index. Furthermore, both ADC and FA ratios, derived from DTI, were useful for quantitatively predicting the Ki-67 labeling of glioma cells.
Collapse
|
20
|
Liau CT, Chou WC, Wei KC, Chang CN, Toh CH, Jung SM. Female sex, good performance status, and bevacizumab-induced hypertension associated with survival benefit in Asian patients with recurrent glioblastoma treated with bevacizumab. Asia Pac J Clin Oncol 2017; 14:e8-e14. [PMID: 28792121 DOI: 10.1111/ajco.12747] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Accepted: 06/05/2017] [Indexed: 11/30/2022]
Abstract
AIM The goals of this study were to assess the activity and safety profile of bevacizumab in Taiwan Chinese patients with recurrent glioblastoma, to determine whether their response differed from that reported in other clinical trials, and to examine potential prognostic factors for survival. METHODS We retrospectively assessed patients who received bevacizumab for recurrent glioblastoma between 2012 and 2015. Twelve predefined variables and the outcomes of our cohort were analyzed. RESULTS In total, 76 patients with recurrent glioblastoma were analyzed. The overall response rate was 59.2%, including 19 patients (25.0%) with complete response and 26 patients (34.2%) with partial response. The median progression-free survival and overall survival were 5.2 months (95% confidence interval [CI], 4.6-5.8 months) and 7.8 months (95% CI, 5.8-9.8 months), respectively. Multivariate analysis identified sex and grade 3 posttreatment hypertension (systolic ≥ 160 mmHg or diastolic ≥ 100 mmHg) as the only independent predictive factors for progression-free survival and overall survival. Eastern Cooperative Oncology Group performance status was also found to be independently predictive of improved overall survival. CONCLUSION We showed good responses using bevacizumab and the progression-free survival and overall survival were comparable with those previously reported. The adverse events of bevacizumab in our study were generally acceptable and manageable. Female sex, good performance status, and grade 3 posttreatment hypertension were suggested to be associated with survival benefits.
Collapse
Affiliation(s)
- Chi-Ting Liau
- Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Tao-Yuan, Taiwan
| | - Wen-Chi Chou
- Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Tao-Yuan, Taiwan
| | - Kuo-Chen Wei
- Department of Neurosurgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Tao-Yuan, Taiwan
| | - Chen-Nen Chang
- Department of Neurosurgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Tao-Yuan, Taiwan
| | - Cheng-Hong Toh
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Tao-Yuan, Taiwan
| | - Shih-Ming Jung
- Department of Pathology, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Tao-Yuan, Taiwan
| |
Collapse
|
21
|
Goryaynov SA, Gol'dberg MF, Golanov AV, Zolotova SV, Shishkina LV, Ryzhova MV, Pitskhelauri DI, Zhukov VY, Usachev DY, Belyaev AY, Kondrashov AV, Shurkhay VA, Potapov AA. [The phenomenon of long-term survival in glioblastoma patients. Part I: the role of clinical and demographic factors and an IDH1 mutation (R 132 H)]. ZHURNAL VOPROSY NEIROKHIRURGII IMENI N. N. BURDENKO 2017; 81:5-16. [PMID: 28665384 DOI: 10.17116/neiro20178135-16] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
UNLABELLED The median overall survival of glioblastoma patients is about 15 months. Only a small number of patients survive 3 years. The factors of a favorable prognosis for the 'longevity phenomenon' in glioblastoma patients are not fully understood. OBJECTIVE to determine the occurrence rate of long-living patients with glioblastomas, identify clinical predictors of a favorable prognosis, and identify the presence and prognostic significance of an IDH1 mutation. MATERIAL AND METHODS Among 1494 patients operated on for glioblastoma at the Burdenko Neurosurgical Institute from 2007 to 2012, there were 84 (5.6%) patients who lived more than 3 years after primary surgery. In all the cases, histological specimens were reviewed, and immunohistochemical detection of a mutant IDH1 protein was performed. Overall survival was calculated from the time of first surgery to the date of the last consultation or death, and the recurrence-free period was calculated from the time of first surgery to MRI-verified tumor progression. RESULTS The median age of long-living patients with glioblastoma was 45 years (19-65 years). All tumors were located supratentorially. The median Karnofsky performance status score at the time of surgery was 80 (range, 70-100). All patients underwent microsurgical resection of the tumor, followed by chemoradiotherapy. The median recurrence-free period was 36 months (5-98 months). Overall survival of 48, 60, and 84 months was achieved in 23, 15 and 6% of patients, respectively. Among 49 specimens available for the IDH1 analysis, 14 (28.6%) specimens had a mutant protein. There was no significant difference in survival rates in patients with positive and negative results for IDH1 (44.1 vs. 40.8 months; p>0.05). CONCLUSION The significance of various factors that may be predictors of a favorable course of the disease is discussed in the literature. This work is the first part of analysis of prognostically significant factors positively affecting overall survival of glioblastoma patients. In our series, the predictors of a favorable prognosis for long-living patients with the verified diagnosis of glioblastoma were as follows: young age, the supratentorial location of the tumor, a high Karnofsky score before surgery, and tumor resection. In our series, we used immunohistochemical tests and found no prognostic significance of the IDH1 gene mutation; further analysis will require application of direct sequencing. We plan to study other morphological and molecular genetic features of tumors, which explain prolonged survival of glioblastoma patients, as well as the role of various types of combined chemoradiation treatment.
Collapse
Affiliation(s)
| | - M F Gol'dberg
- Burdenko Neurosurgical Institute, Moscow, Russia; Sechenov First Moscow State Medical University, Moscow, Russia
| | - A V Golanov
- Burdenko Neurosurgical Institute, Moscow, Russia
| | - S V Zolotova
- Burdenko Neurosurgical Institute, Moscow, Russia
| | | | - M V Ryzhova
- Burdenko Neurosurgical Institute, Moscow, Russia
| | - D I Pitskhelauri
- Burdenko Neurosurgical Institute, Moscow, Russia, Sechenov First Moscow State Medical University, Moscow, Russia
| | - V Yu Zhukov
- Burdenko Neurosurgical Institute, Moscow, Russia
| | - D Yu Usachev
- Burdenko Neurosurgical Institute, Moscow, Russia
| | - A Yu Belyaev
- Burdenko Neurosurgical Institute, Moscow, Russia
| | - A V Kondrashov
- Sechenov First Moscow State Medical University, Moscow, Russia
| | - V A Shurkhay
- Burdenko Neurosurgical Institute, Moscow, Russia
| | - A A Potapov
- Burdenko Neurosurgical Institute, Moscow, Russia
| |
Collapse
|
22
|
Gefroh-Grimes HA, Gidal BE. Antiepileptic drugs in patients with malignant brain tumor: beyond seizures and pharmacokinetics. Acta Neurol Scand 2016; 133:4-16. [PMID: 25996875 DOI: 10.1111/ane.12437] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2015] [Indexed: 02/06/2023]
Abstract
In neurological malignancies, antiepileptic drugs (AEDs) are frequently used to control the seizure activity that accompanies the disorder. There is a growing body of evidence on the importance of AED selection for reasons other than pharmacokinetics (PK) properties. Epigenetic modifications may occur in glioblastomas, such as changes in gene methylation and histone acetylation states. Secondary mechanisms of AED drug action which impact these epigenetic modifications could play a significant role in patient survival outcomes. Both valproic acid (VPA) and carbamazepine have histone deacetylase (HDAC) inhibitory activities, and levetiracetam and VPA reduce the activity of O6-methylguanine-DNA methyltransferase (MGMT), a DNA-repair molecule implicated in resistance to alkylating agents used for chemotherapy. The use of AEDs for purposes other than seizure prophylaxis and their selection based on non-PK properties present a potential paradigm shift in the field of neuro-oncology.
Collapse
Affiliation(s)
- H. A. Gefroh-Grimes
- Pharmacy Practice Division; School of Pharmacy; University of Wisconsin-Madison; Madison WI USA
| | - B. E. Gidal
- School of Pharmacy & Department of Neurology; University of Wisconsin-Madison; Madison WI USA
| |
Collapse
|
23
|
Wang K, Wang Y, Fan X, Wang J, Li G, Ma J, Ma J, Jiang T, Dai J. Radiological features combined with IDH1 status for predicting the survival outcome of glioblastoma patients. Neuro Oncol 2015; 18:589-97. [PMID: 26409566 DOI: 10.1093/neuonc/nov239] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 08/24/2015] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Radiological characteristics may reflect the biological features of brain tumors and may be associated with genetic alterations that occur in tumorigenesis. This study aimed to investigate the relationship between radiological features and IDH1 status as well as their predictive value for survival of glioblastoma patients. METHODS The clinical information and MR images of 280 patients with histologically confirmed glioblastoma were retrospectively reviewed. The radiological characteristics of tumors were examined on MR images, and the IDH1 status was determined using DNA sequencing for all cases. The Kaplan-Meier method and Cox regression model were used to identify prognostic factors for progression-free and overall survival. RESULTS The IDH1 mutation was associated with longer progression-free survival (P = .022; hazard ratio, 0.602) and overall survival (P = .018; hazard ratio, 0.554). In patients with the IDH1 mutation, tumor contrast enhancement and peritumoral edema indicated worse progression-free survival (P = .015 and P = .024, respectively) and worse overall survival (P = .024 and P = .032, respectively). For tumors with contrast enhancement, multifocal contrast enhancement of the tumor lesion was associated with poor progression-free survival (P = .002) and poor overall survival (P = .010) in patients with wild-type IDH1 tumors. CONCLUSIONS Combining the radiological features and IDH1 status of a tumor allows more accurate prediction of survival outcomes in glioblastoma patients. The complementary roles of genetic changes and radiological features of tumors should be considered in future studies.
Collapse
Affiliation(s)
- Kai Wang
- Department of Neuroradiology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China (K.W., J.M., J.M., J.D.); Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China (Y.W., X.F., J.W., T.J.); Department of Pathology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China (G.L.); Beijing Neurosurgical Institute, Capital Medical University, Beijing, China (Y.W., X.F., T.J., J.D.); Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing, China (T.J.)
| | - Yinyan Wang
- Department of Neuroradiology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China (K.W., J.M., J.M., J.D.); Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China (Y.W., X.F., J.W., T.J.); Department of Pathology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China (G.L.); Beijing Neurosurgical Institute, Capital Medical University, Beijing, China (Y.W., X.F., T.J., J.D.); Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing, China (T.J.)
| | - Xing Fan
- Department of Neuroradiology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China (K.W., J.M., J.M., J.D.); Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China (Y.W., X.F., J.W., T.J.); Department of Pathology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China (G.L.); Beijing Neurosurgical Institute, Capital Medical University, Beijing, China (Y.W., X.F., T.J., J.D.); Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing, China (T.J.)
| | - Jiangfei Wang
- Department of Neuroradiology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China (K.W., J.M., J.M., J.D.); Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China (Y.W., X.F., J.W., T.J.); Department of Pathology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China (G.L.); Beijing Neurosurgical Institute, Capital Medical University, Beijing, China (Y.W., X.F., T.J., J.D.); Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing, China (T.J.)
| | - Guilin Li
- Department of Neuroradiology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China (K.W., J.M., J.M., J.D.); Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China (Y.W., X.F., J.W., T.J.); Department of Pathology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China (G.L.); Beijing Neurosurgical Institute, Capital Medical University, Beijing, China (Y.W., X.F., T.J., J.D.); Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing, China (T.J.)
| | - Jieling Ma
- Department of Neuroradiology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China (K.W., J.M., J.M., J.D.); Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China (Y.W., X.F., J.W., T.J.); Department of Pathology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China (G.L.); Beijing Neurosurgical Institute, Capital Medical University, Beijing, China (Y.W., X.F., T.J., J.D.); Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing, China (T.J.)
| | - Jun Ma
- Department of Neuroradiology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China (K.W., J.M., J.M., J.D.); Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China (Y.W., X.F., J.W., T.J.); Department of Pathology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China (G.L.); Beijing Neurosurgical Institute, Capital Medical University, Beijing, China (Y.W., X.F., T.J., J.D.); Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing, China (T.J.)
| | - Tao Jiang
- Department of Neuroradiology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China (K.W., J.M., J.M., J.D.); Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China (Y.W., X.F., J.W., T.J.); Department of Pathology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China (G.L.); Beijing Neurosurgical Institute, Capital Medical University, Beijing, China (Y.W., X.F., T.J., J.D.); Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing, China (T.J.)
| | - Jianping Dai
- Department of Neuroradiology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China (K.W., J.M., J.M., J.D.); Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China (Y.W., X.F., J.W., T.J.); Department of Pathology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China (G.L.); Beijing Neurosurgical Institute, Capital Medical University, Beijing, China (Y.W., X.F., T.J., J.D.); Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing, China (T.J.)
| |
Collapse
|
24
|
Schweneker K, Clemm C, Brügel M, Souvatzoglou M, Hermisson M, Schmidt-Graf F, Zimmer C, Peschel C, Jost PJ. Effective long-term treatment with bevacizumab for relapsed glioblastoma: case report and review of the literature. Exp Hematol Oncol 2014; 3:29. [PMID: 25954595 PMCID: PMC4423626 DOI: 10.1186/2162-3619-3-29] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 12/12/2014] [Indexed: 11/17/2022] Open
Abstract
Glioblastoma multiforme (GBM) is the most common malignant primary brain tumor in adults. Despite the use of optimized first-line therapy, GBM is still associated with a poor prognosis and an effective second-line therapy remains an important challenge in this patient population. In 2009, the US Food and Drug Administration (FDA) approved the monoclonal anti-VEGF-antibody bevacizumab for the treatment of relapsed GBM after two phase-II studies showed its efficacy and safety, alone or in combination with irinotecan, in relapsed GBM. In contrast, the European Medicines Agency (EMA) concluded from the same published data that a clear benefit in terms of overall survival was not shown and subsequently did not grant approval for bevacizumab in this setting. Here, we report on a 53-year old patient with relapsed GBM who was treated with bevacizumab as single agent. After three months, the tumor volume was reduced and the Karnofsky performance status was substantially improved compared to the baseline at the time of relapse. After continued long-term treatment for 26 months, the patient remains in an excellent general condition. Moreover, the measurement of the tumor volume using multiple imaging modalities shows a sustained treatment response. In conclusion, this case supports the notion that individual patients respond exceptionally well to treatment with anti-VEGF therapy and suggests that future trials are needed to better identify the patient population that responds to bevacizumab.
Collapse
Affiliation(s)
| | | | - Melanie Brügel
- Institut für Diagnostische und Interventionelle Radiologie, München, Germany
| | | | | | | | - Claus Zimmer
- Abteilung für Diagnostische und Interventionelle Neuroradiologie, Klinikum rechts der Isar, Technische Universität München, 81675 München, Germany
| | | | | |
Collapse
|
25
|
Gerber NK, Goenka A, Turcan S, Reyngold M, Makarov V, Kannan K, Beal K, Omuro A, Yamada Y, Gutin P, Brennan CW, Huse JT, Chan TA. Transcriptional diversity of long-term glioblastoma survivors. Neuro Oncol 2014; 16:1186-95. [PMID: 24662514 DOI: 10.1093/neuonc/nou043] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Glioblastoma (GBM) is a highly aggressive type of glioma with poor prognosis. However, a small number of patients live much longer than the median survival. A better understanding of these long-term survivors (LTSs) may provide important insight into the biology of GBM. METHODS We identified 7 patients with GBM, treated at Memorial Sloan-Kettering Cancer Center (MSKCC), with survival >48 months. We characterized the transcriptome of each patient and determined rates of MGMT promoter methylation and IDH1 and IDH2 mutational status. We identified LTSs in 2 independent cohorts (The Cancer Genome Atlas [TCGA] and NCI Repository for Molecular Brain Neoplasia Data [REMBRANDT]) and analyzed the transcriptomal characteristics of these LTSs. RESULTS The median overall survival of our cohort was 62.5 months. LTSs were distributed between the proneural (n = 2), neural (n = 2), classical (n = 2), and mesenchymal (n = 1) subtypes. Similarly, LTS in the TCGA and REMBRANDT cohorts demonstrated diverse transcriptomal subclassification identities. The majority of the MSKCC LTSs (71%) were found to have methylation of the MGMT promoter. None of the patients had an IDH1 or IDH2 mutation, and IDH mutation occurred in a minority of the TCGA LTSs as well. A set of 60 genes was found to be differentially expressed in the MSKCC and TCGA LTSs. CONCLUSIONS While IDH mutant proneural tumors impart a better prognosis in the short-term, survival beyond 4 years does not require IDH mutation and is not dictated by a single transcriptional subclass. In contrast, MGMT methylation continues to have strong prognostic value for survival beyond 4 years. These findings have substantial impact for understanding GBM biology and progression.
Collapse
Affiliation(s)
- Naamit K Gerber
- Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (N.K.G., A.G., M.R., K.B., Y.Y., T.A.C.); Human Oncology and Pathogenesis Program, Memorial Sloan-Kettering Cancer Center, New York, New York (S.T., V.M., K.K., T.A.C.); Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, New York (A.O.); Department of Neurosurgery, Memorial Sloan-Kettering Cancer Center, New York, New York (P.G., C.W.B.); Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York (J.T.H.)
| | - Anuj Goenka
- Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (N.K.G., A.G., M.R., K.B., Y.Y., T.A.C.); Human Oncology and Pathogenesis Program, Memorial Sloan-Kettering Cancer Center, New York, New York (S.T., V.M., K.K., T.A.C.); Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, New York (A.O.); Department of Neurosurgery, Memorial Sloan-Kettering Cancer Center, New York, New York (P.G., C.W.B.); Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York (J.T.H.)
| | - Sevin Turcan
- Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (N.K.G., A.G., M.R., K.B., Y.Y., T.A.C.); Human Oncology and Pathogenesis Program, Memorial Sloan-Kettering Cancer Center, New York, New York (S.T., V.M., K.K., T.A.C.); Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, New York (A.O.); Department of Neurosurgery, Memorial Sloan-Kettering Cancer Center, New York, New York (P.G., C.W.B.); Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York (J.T.H.)
| | - Marsha Reyngold
- Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (N.K.G., A.G., M.R., K.B., Y.Y., T.A.C.); Human Oncology and Pathogenesis Program, Memorial Sloan-Kettering Cancer Center, New York, New York (S.T., V.M., K.K., T.A.C.); Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, New York (A.O.); Department of Neurosurgery, Memorial Sloan-Kettering Cancer Center, New York, New York (P.G., C.W.B.); Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York (J.T.H.)
| | - Vladimir Makarov
- Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (N.K.G., A.G., M.R., K.B., Y.Y., T.A.C.); Human Oncology and Pathogenesis Program, Memorial Sloan-Kettering Cancer Center, New York, New York (S.T., V.M., K.K., T.A.C.); Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, New York (A.O.); Department of Neurosurgery, Memorial Sloan-Kettering Cancer Center, New York, New York (P.G., C.W.B.); Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York (J.T.H.)
| | - Kasthuri Kannan
- Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (N.K.G., A.G., M.R., K.B., Y.Y., T.A.C.); Human Oncology and Pathogenesis Program, Memorial Sloan-Kettering Cancer Center, New York, New York (S.T., V.M., K.K., T.A.C.); Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, New York (A.O.); Department of Neurosurgery, Memorial Sloan-Kettering Cancer Center, New York, New York (P.G., C.W.B.); Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York (J.T.H.)
| | - Kathryn Beal
- Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (N.K.G., A.G., M.R., K.B., Y.Y., T.A.C.); Human Oncology and Pathogenesis Program, Memorial Sloan-Kettering Cancer Center, New York, New York (S.T., V.M., K.K., T.A.C.); Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, New York (A.O.); Department of Neurosurgery, Memorial Sloan-Kettering Cancer Center, New York, New York (P.G., C.W.B.); Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York (J.T.H.)
| | - Antonio Omuro
- Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (N.K.G., A.G., M.R., K.B., Y.Y., T.A.C.); Human Oncology and Pathogenesis Program, Memorial Sloan-Kettering Cancer Center, New York, New York (S.T., V.M., K.K., T.A.C.); Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, New York (A.O.); Department of Neurosurgery, Memorial Sloan-Kettering Cancer Center, New York, New York (P.G., C.W.B.); Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York (J.T.H.)
| | - Yoshiya Yamada
- Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (N.K.G., A.G., M.R., K.B., Y.Y., T.A.C.); Human Oncology and Pathogenesis Program, Memorial Sloan-Kettering Cancer Center, New York, New York (S.T., V.M., K.K., T.A.C.); Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, New York (A.O.); Department of Neurosurgery, Memorial Sloan-Kettering Cancer Center, New York, New York (P.G., C.W.B.); Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York (J.T.H.)
| | - Phillip Gutin
- Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (N.K.G., A.G., M.R., K.B., Y.Y., T.A.C.); Human Oncology and Pathogenesis Program, Memorial Sloan-Kettering Cancer Center, New York, New York (S.T., V.M., K.K., T.A.C.); Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, New York (A.O.); Department of Neurosurgery, Memorial Sloan-Kettering Cancer Center, New York, New York (P.G., C.W.B.); Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York (J.T.H.)
| | - Cameron W Brennan
- Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (N.K.G., A.G., M.R., K.B., Y.Y., T.A.C.); Human Oncology and Pathogenesis Program, Memorial Sloan-Kettering Cancer Center, New York, New York (S.T., V.M., K.K., T.A.C.); Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, New York (A.O.); Department of Neurosurgery, Memorial Sloan-Kettering Cancer Center, New York, New York (P.G., C.W.B.); Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York (J.T.H.)
| | - Jason T Huse
- Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (N.K.G., A.G., M.R., K.B., Y.Y., T.A.C.); Human Oncology and Pathogenesis Program, Memorial Sloan-Kettering Cancer Center, New York, New York (S.T., V.M., K.K., T.A.C.); Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, New York (A.O.); Department of Neurosurgery, Memorial Sloan-Kettering Cancer Center, New York, New York (P.G., C.W.B.); Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York (J.T.H.)
| | - Timothy A Chan
- Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (N.K.G., A.G., M.R., K.B., Y.Y., T.A.C.); Human Oncology and Pathogenesis Program, Memorial Sloan-Kettering Cancer Center, New York, New York (S.T., V.M., K.K., T.A.C.); Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, New York (A.O.); Department of Neurosurgery, Memorial Sloan-Kettering Cancer Center, New York, New York (P.G., C.W.B.); Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York (J.T.H.)
| |
Collapse
|
26
|
Yang M, Yuan Y, Zhang H, Yan M, Wang S, Feng F, Ji P, Li Y, Li B, Gao G, Zhao J, Wang L. Prognostic significance of CD147 in patients with glioblastoma. J Neurooncol 2013; 115:19-26. [PMID: 23925827 DOI: 10.1007/s11060-013-1207-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2012] [Accepted: 07/15/2013] [Indexed: 12/21/2022]
Abstract
CD147, also known as extracellular matrix metalloproteinase inducer, is a widely distributed cell surface glycoprotein that belongs to the immunoglobulin superfamily. CD147 has been proved to be enriched on the surface of many tumor cells, promoting tumor growth, invasion and metastasis by its stimulation effect on adjacent fibroblasts to produce matrix metalloproteinases. In this study, we aimed to explore the expression pattern of CD147 in glioblastoma (GBM) and investigate whether it could be used to assess subsequent prognosis of patients. For that, we recruited a total of 206 patients with pathologically confirmed GBM and 36 normal control brain tissue specimens. The expression of CD147 in GBM and normal tissues was investigated by immunohistochemistry assay. Genetic factors including MGMT and IDH1 mutation were also investigated to justify the prognostic significance of CD147. Results showed that CD147 expression was increased in GBM compared with that in normal tissues. Kaplan-Meier analysis showed that increased CD147 expression was associated with poor overall survival of patients with GBM. Moreover, Cox's proportional hazards model revealed that CD147 expression was an independent and significant prognostic marker of overall survival in GBM patients. These results proved that CD147 expression was relatively abundant in GBM and can be potentially used to predict prognosis and treatment response in GBM patients.
Collapse
Affiliation(s)
- Min Yang
- Institute of Orthopaedics and Traumatology of PLA of China, Xijing Hospital, The Fourth Military Medical University, Xi'an, 710032, Shaanxi, People's Republic of China
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|