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Duffau H. A Personalized Longitudinal Strategy in Low-Grade Glioma Patients: Predicting Oncological and Neural Interindividual Variability and Its Changes over Years to Think One Step Ahead. J Pers Med 2022; 12:jpm12101621. [PMID: 36294760 PMCID: PMC9604939 DOI: 10.3390/jpm12101621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 09/15/2022] [Accepted: 09/22/2022] [Indexed: 11/09/2022] Open
Abstract
Diffuse low-grade glioma (LGG) is a rare cerebral cancer, mostly involving young adults with an active life at diagnosis. If left untreated, LGG widely invades the brain and becomes malignant, generating neurological worsening and ultimately death. Early and repeat treatments for this incurable tumor, including maximal connectome-based surgical resection(s) in awake patients, enable postponement of malignant transformation while preserving quality of life owing to constant neural network reconfiguration. Due to considerable interindividual variability in terms of LGG course and consecutive cerebral reorganization, a multistage longitudinal strategy should be tailored accordingly in each patient. It is crucial to predict how the glioma will progress (changes in growth rate and pattern of migration, genetic mutation, etc.) and how the brain will adapt (changes in patterns of spatiotemporal redistribution, possible functional consequences such as epilepsy or cognitive decline, etc.). The goal is to anticipate therapeutic management, remaining one step ahead in order to select the optimal (re-)treatment(s) (some of them possibly kept in reserve), at the appropriate time(s) in the evolution of this chronic disease, before malignization and clinical worsening. Here, predictive tumoral and non-tumoral factors, and their ever-changing interactions, are reviewed to guide individual decisions in advance based on patient-specific markers, for the treatment of LGG.
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Affiliation(s)
- Hugues Duffau
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, 80 Av. Augustin Fliche, 34295 Montpellier, France; ; Tel.: +33-4-67-33-66-12; Fax: +33-4-67-33-69-12
- Team “Plasticity of Central Nervous System, Stem Cells and Glial Tumors”, National Institute for Health and Medical Research (INSERM), U1191 Laboratory, Institute of Functional Genomics, University of Montpellier, 34091 Montpellier, France
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Vasilica AM, Sefcikova V, Samandouras G. Genetic alterations in non-syndromic, familial gliomas in first degree relatives: A systematic review. Clin Neurol Neurosurg 2020; 198:106222. [PMID: 33039851 DOI: 10.1016/j.clineuro.2020.106222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 08/29/2020] [Accepted: 09/06/2020] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Despite numerous reports in syndromic gliomas, the underlying genetic and molecular basis of familial, non-syndromic gliomas, in first degree relatives, remains unclear. This rare cohort of patients harboring invasive primary brain tumors with poor prognosis may provide a potential substrate of understanding the complex genetic cascade triggering tumorigenesis. METHODS A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) 2015 and The Cochrane Handbook of Systematic Reviews of Interventions. PubMed/MEDLINE, Embase and CENTRAL databases were accessed with set inclusion and exclusion criteria. RESULTS Following returns of 6756 articles, systematic analysis resulted in 48 papers, with 18 case series, 4 linkage analysis, 3 case-control studies, 1 cohort study, and 22 case reports. A total of 164 first degree relatives of 72 families were analyzed. The most common genetic alterations associated with non-syndromic familial gliomas reported to affect chromosomes 17 (51.1 % germline and 9.3 % tumor mutations), 22 (15.6 % germline and 6 % tumor mutations) and 1 and 19 (4.4 % germline and 9.3 % tumor mutations), with the most commonly affected genes TP53 (8.5 %) and NF2 (3.7 %). Tumor suppressors or cell-cycle regulators, cell signaling and transcription regulation or methylation were the most common gene function categories. CONCLUSION Four specific chromosomes (17, 22, 1 and 19) and two specific genes (TP53 and NF2) appear to be most commonly involved. This appears to be the first systematic review of genetic factors underlying non-syndromic glioma clustering in families. The defined list of genetic abnormalities, linked to familial gliomas, may facilitate therapeutic targets and future treatment design.
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Affiliation(s)
| | - Viktoria Sefcikova
- UCL Queen Square Institute of Neurology, University College London, Queen Square, London, United Kingdom.
| | - George Samandouras
- UCL Queen Square Institute of Neurology, University College London, Queen Square, London, United Kingdom; Victor Horsley Department of Neurosurgery, The National Hospital for Neurology and Neurosurgery, Queen Square, London, United Kingdom.
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Lee S, Kambhampati M, Almira-Suarez MI, Ho CY, Panditharatna E, Berger SI, Turner J, Van Mater D, Kilburn L, Packer RJ, Myseros JS, Vilain E, Nazarian J, Bornhorst M. Somatic Mosaicism of IDH1 R132H Predisposes to Anaplastic Astrocytoma: A Case of Two Siblings. Front Oncol 2020; 9:1507. [PMID: 32010615 PMCID: PMC6971203 DOI: 10.3389/fonc.2019.01507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 12/16/2019] [Indexed: 12/03/2022] Open
Abstract
Anaplastic astrocytomas are aggressive glial cancers that present poor prognosis and high recurrence. Heterozygous IDH1 R132H mutations are common in adolescent and young adult anaplastic astrocytomas. In a majority of cases, the IDH1 R132H mutation is unique to the tumor, although rare cases of anaplastic astrocytoma have been described in patients with mosaic IDH1 mutations (Ollier disease or Maffucci syndrome). Here, we present two siblings with IDH1 R132H mutant high grade astrocytomas diagnosed at 14 and 26 years of age. Analysis of IDHR132H mutations in the siblings' tumors and non-neoplastic tissues, including healthy regions of the brain, cheek cells, and primary teeth indicate mosaicism of IDHR132H. Whole exome sequencing of the tumor tissue did not reveal any other common mutations between the two siblings. This study demonstrates the first example of IDH1 R132H mosaicism, acquired during early development, that provides an alternative mechanism of cancer predisposition.
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Affiliation(s)
- Sulgi Lee
- Center for Genetic Medicine, Children's National Health System, Washington, DC, United States.,Institute for Biomedical Sciences, The George Washington University School of Medicine and Health Sciences, Washington, DC, United States
| | - Madhuri Kambhampati
- Center for Genetic Medicine, Children's National Health System, Washington, DC, United States
| | - M Isabel Almira-Suarez
- Department of Pathology and Laboratory Medicine, Children's National Health System, Washington, DC, United States
| | - Cheng-Ying Ho
- Department of Pathology and Neurology, University of Maryland School of Medicine, Baltimore, MD, United States
| | | | - Seth I Berger
- Center for Genetic Medicine, Children's National Health System, Washington, DC, United States.,Department of Genomics and Precision Medicine, The George Washington University School of Medicine and Health Sciences, Washington, DC, United States.,Rare Disease Institute, Children's National Health System, Washington, DC, United States.,Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, DC, United States
| | - Joyce Turner
- Division of Genetics and Metabolism, Children's National Health System, Washington, DC, United States.,Division of Oncology, Children's National Health System, Washington, DC, United States
| | - David Van Mater
- Division of Pediatric Hematology Oncology, Department of Pediatrics, Duke University Medical Center, Durham, NC, United States
| | - Lindsay Kilburn
- Division of Oncology, Children's National Health System, Washington, DC, United States.,Brain Tumor Institute, Children's National Health System, Washington, DC, United States
| | - Roger J Packer
- Brain Tumor Institute, Children's National Health System, Washington, DC, United States
| | - John S Myseros
- Division of Neurosurgery, Children's National Health System, Washington, DC, United States
| | - Eric Vilain
- Center for Genetic Medicine, Children's National Health System, Washington, DC, United States.,Department of Genomics and Precision Medicine, The George Washington University School of Medicine and Health Sciences, Washington, DC, United States
| | - Javad Nazarian
- Center for Genetic Medicine, Children's National Health System, Washington, DC, United States.,Institute for Biomedical Sciences, The George Washington University School of Medicine and Health Sciences, Washington, DC, United States.,Department of Genomics and Precision Medicine, The George Washington University School of Medicine and Health Sciences, Washington, DC, United States.,Brain Tumor Institute, Children's National Health System, Washington, DC, United States.,University Children's Hospital Zurich, Zurich, Switzerland
| | - Miriam Bornhorst
- Center for Genetic Medicine, Children's National Health System, Washington, DC, United States.,Division of Oncology, Children's National Health System, Washington, DC, United States.,Brain Tumor Institute, Children's National Health System, Washington, DC, United States
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Berger MS, Hervey-Jumper S, Wick W. Astrocytic gliomas WHO grades II and III. HANDBOOK OF CLINICAL NEUROLOGY 2016; 134:345-60. [PMID: 26948365 DOI: 10.1016/b978-0-12-802997-8.00021-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
World Health Organization grades II and III lower-grade astrocytomas are a challenging area in neuro-oncology. One the one hand, for proper diagnosis, the analysis of molecular factors, especially mutation status of isocitrate dehydrogenase and 1p/19q status in the tumor status needs to be done in addition to classical neuropathology. Further, the high clinical and prognostic value of a maximal safe resection requires a profound knowledge of presurgical diagnosis and surgical as well as imaging techniques to ensure optimal outcome for patients. Also medical treatment may be more intensive than previously believed, with randomized trials providing evidence for a benefit in overall survival by combined chemoradiation versus radiation alone. A critical problem concerns the considerable undesirable effects of therapeutic interventions on long-term health-related quality of life, cognitive and functional outcome as well as future developments in this still difficult disease that will need to be addressed in future trials.
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Affiliation(s)
- Mitchel S Berger
- Department of Neurological Surgery, University of California, San Francisco, CA, USA.
| | - Shawn Hervey-Jumper
- Department of Neurological Surgery, Taubman Health Center, Ann Arbor, MI, USA
| | - Wolfgang Wick
- Department of Neurooncology, University Clinic of Heidelberg, Heidelberg, Germany
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Abstract
Cardiac glycosides induce apoptotic effects on glioma cells, but whether cardiac glycosides protect against risk for glioma is unknown. We therefore explored the relation between glycoside use and glioma risk using a large and validated database. We performed a case-control analysis using the Clinical Practice Research Datalink involving 2005 glioma cases diagnosed between 1995 and 2012 that were individually matched to 20,050 controls on age, gender, general practice, and number of years of active history in the database. Conditional logistic regression analysis was used to evaluate the association between cardiac glycosides and the risk of glioma adjusting for body mass index and smoking. We also examined use of common heart failure and arrhythmia medications to differentiate between a specific glycoside effect and a generic effect of treatment for congestive heart failure or arrhythmia. Cardiac glycoside use was inversely related to glioma incidence. After adjustment for congestive heart failure, arrhythmia, diabetes, and common medications used to treat those conditions, the OR of glioma was 0.47 (95% CI 0.27-0.81, Bonferroni-corrected p value = 0.024) for use versus non-use of cardiac glycosides, based on 17 exposed cases. In contrast, no associations were noted for other medications used to treat congestive heart failure or arrhythmias. The OR of glioma in people with congestive heart failure was 0.65 (95% CI 0.40-1.04), and for arrhythmia it was 1.01 (95% CI 0.78-1.31). These data indicate that cardiac glycoside use is independently associated with reduced glioma risk.
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