1
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Miele E, Anghileri E, Calatozzolo C, Lazzarini E, Patrizi S, Ciolfi A, Pedace L, Patanè M, Abballe L, Paterra R, Maddaloni L, Barresi S, Mastronuzzi A, Petruzzi A, Tramacere I, Farinotti M, Gurrieri L, Pirola E, Scarpelli M, Lombardi G, Villani V, Simonelli M, Merli R, Salmaggi A, Tartaglia M, Silvani A, DiMeco F, Calistri D, Lamperti E, Locatelli F, Indraccolo S, Pollo B. Clinicopathological and molecular landscape of 5-year IDH-wild-type glioblastoma survivors: A multicentric retrospective study. Cancer Lett 2024; 588:216711. [PMID: 38423245 DOI: 10.1016/j.canlet.2024.216711] [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: 10/24/2023] [Revised: 01/19/2024] [Accepted: 02/05/2024] [Indexed: 03/02/2024]
Abstract
Five-year glioblastoma (GBM) survivors (LTS) are the minority of the isocitrate dehydrogenase (IDH)-wild-type GBM patients, and their molecular fingerprint is still largely unexplored. This multicenter retrospective study analyzed a large LTS-GBM cohort from nine Italian institutions and molecularly characterized a subgroup of patients by mutation, DNA methylation (DNAm) and copy number variation (CNV) profiling, comparing it to standard survival GBM. Mutation scan allowed the identification of pathogenic variants in most cases, showing a similar mutational spectrum in both groups, and highlighted TP53 as the most commonly mutated gene in the LTS group. We confirmed DNAm as a valuable tool for GBM classification with a diagnostic refinement by using brain tumor classifier v12.5. LTS were more heterogeneous with more cases classified as diffuse pediatric high-grade glioma subtypes and having peculiar CNVs. We observed a global higher methylation in CpG islands and in gene promoters of LTS with methylation levels of distinct gene promoters correlating with prognosis.
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Affiliation(s)
- Evelina Miele
- Department of Onco-Hematology, Cell Therapy, Gene Therapies and Hemopoietic Transplant, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Elena Anghileri
- Neuro-Oncology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta (FINCB), Milan, Italy.
| | - Chiara Calatozzolo
- Neuropathology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Elisabetta Lazzarini
- Basic and Translational Oncology Unit, Istituto Oncologico Veneto (IOV)-IRCCS, Padua, Italy
| | - Sara Patrizi
- Department of Onco-Hematology, Cell Therapy, Gene Therapies and Hemopoietic Transplant, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Andrea Ciolfi
- Molecular Genetics and Functional Genomics Research Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Lucia Pedace
- Department of Onco-Hematology, Cell Therapy, Gene Therapies and Hemopoietic Transplant, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Monica Patanè
- Neuropathology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Luana Abballe
- Department of Onco-Hematology, Cell Therapy, Gene Therapies and Hemopoietic Transplant, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Rosina Paterra
- Neuro-Oncology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta (FINCB), Milan, Italy
| | - Luisa Maddaloni
- Neuro-Oncology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta (FINCB), Milan, Italy
| | - Sabina Barresi
- Pathology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Angela Mastronuzzi
- Department of Onco-Hematology, Cell Therapy, Gene Therapies and Hemopoietic Transplant, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Alessandra Petruzzi
- Neuro-Oncology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta (FINCB), Milan, Italy
| | - Irene Tramacere
- Department of Research and Clinical Development, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Mariangela Farinotti
- Neuroepidemiology-Brain Cancer Registry, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Lorena Gurrieri
- Osteoncology and Rare Tumors Center, IRCCS Istituto Romagnolo Per Lo Studio Dei Tumori (IRST) Dino Amadori, Meldola, Italy
| | - Elena Pirola
- Department of Neurosurgery Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Mauro Scarpelli
- Neurology Unit, Azienda Ospedaliera Universitaria Integrata Verona, Italy
| | - Giuseppe Lombardi
- Medical Oncology Unit 1, Istituto Oncologico Veneto IOV-IRCCS, Padua, Italy
| | - Veronica Villani
- Neuro-Oncology Unit, IRCCS Istituto Nazionale Tumori Regina Elena, Rome, Italy
| | - Matteo Simonelli
- Department of Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Rossella Merli
- Neurosurgery Unit, ASST Papa Giovanni XXIII, Bergamo, Italy
| | | | - Marco Tartaglia
- Molecular Genetics and Functional Genomics Research Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Antonio Silvani
- Neuro-Oncology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta (FINCB), Milan, Italy
| | - Francesco DiMeco
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy; Department of Neurological Surgery, John Hopkins Medical School, Baltimore, MD, USA
| | - Daniele Calistri
- Biosciences Laboratory, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, FC, Italy
| | - Elena Lamperti
- Neuro-Oncology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta (FINCB), Milan, Italy
| | - Franco Locatelli
- Department of Onco-Hematology, Cell Therapy, Gene Therapies and Hemopoietic Transplant, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy; Department of Life Sciences and Public Health, Catholic University of the Sacred Heart, Rome, Italy
| | - Stefano Indraccolo
- Basic and Translational Oncology Unit, Istituto Oncologico Veneto (IOV)-IRCCS, Padua, Italy; Department of Surgery Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Bianca Pollo
- Neuropathology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
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2
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Nuechterlein N, Shelbourn A, Cimino PJ. Whole gain of chromosome 19, not co-gain of chromosomes 19 and 20, characterizes a class of glioblastomas with more favorable outcomes. J Neuropathol Exp Neurol 2023; 83:53-57. [PMID: 37964704 PMCID: PMC10746695 DOI: 10.1093/jnen/nlad092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2023] Open
Affiliation(s)
- Nicholas Nuechterlein
- Neuropathology Unit, Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA
| | - Allison Shelbourn
- Neuropathology Unit, Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA
| | - Patrick J Cimino
- Neuropathology Unit, Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA
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3
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Schaufler A, Sanin AY, Sandalcioglu IE, Hartmann K, Croner RS, Perrakis A, Wartmann T, Boese A, Kahlert UD, Fischer I. Concept of a fully-implantable system to monitor tumor recurrence. Sci Rep 2023; 13:16362. [PMID: 37773315 PMCID: PMC10541913 DOI: 10.1038/s41598-023-43226-3] [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: 04/12/2023] [Accepted: 09/21/2023] [Indexed: 10/01/2023] Open
Abstract
Current treatment for glioblastoma includes tumor resection followed by radiation, chemotherapy, and periodic post-operative examinations. Despite combination therapies, patients face a poor prognosis and eventual recurrence, which often occurs at the resection site. With standard MRI imaging surveillance, histologic changes may be overlooked or misinterpreted, leading to erroneous conclusions about the course of adjuvant therapy and subsequent interventions. To address these challenges, we propose an implantable system for accurate continuous recurrence monitoring that employs optical sensing of fluorescently labeled cancer cells and is implanted in the resection cavity during the final stage of tumor resection. We demonstrate the feasibility of the sensing principle using miniaturized system components, optical tissue phantoms, and porcine brain tissue in a series of experimental trials. Subsequently, the system electronics are extended to include circuitry for wireless energy transfer and power management and verified through electromagnetic field, circuit simulations and test of an evaluation board. Finally, a holistic conceptual system design is presented and visualized. This novel approach to monitor glioblastoma patients is intended to early detect recurrent cancerous tissue and enable personalization and optimization of therapy thus potentially improving overall prognosis.
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Affiliation(s)
- Anna Schaufler
- Molecular and Experimental Surgery, Clinic for General-, Visceral-, Vascular - and Transplant Surgery, Faculty of Medicine, Otto-von-Guericke University Magdeburg, 39120, Magdeburg, Germany
- Department of Neurosurgery, Otto-von-Guericke University Magdeburg, 39120, Magdeburg, Germany
- INKA Health Tech Innovation Lab., Medical Faculty, Otto-von-Guericke University Magdeburg, 39120, Magdeburg, Germany
| | - Ahmed Y Sanin
- Molecular and Experimental Surgery, Clinic for General-, Visceral-, Vascular - and Transplant Surgery, Faculty of Medicine, Otto-von-Guericke University Magdeburg, 39120, Magdeburg, Germany
- Research Campus STIMULATE, Otto-von-Guericke University Magdeburg, 39120, Magdeburg, Germany
| | - I Erol Sandalcioglu
- Department of Neurosurgery, Otto-von-Guericke University Magdeburg, 39120, Magdeburg, Germany
| | - Karl Hartmann
- Department of Neurosurgery, Otto-von-Guericke University Magdeburg, 39120, Magdeburg, Germany
| | - Roland S Croner
- Molecular and Experimental Surgery, Clinic for General-, Visceral-, Vascular - and Transplant Surgery, Faculty of Medicine, Otto-von-Guericke University Magdeburg, 39120, Magdeburg, Germany
| | - Aristotelis Perrakis
- Molecular and Experimental Surgery, Clinic for General-, Visceral-, Vascular - and Transplant Surgery, Faculty of Medicine, Otto-von-Guericke University Magdeburg, 39120, Magdeburg, Germany
| | - Thomas Wartmann
- Molecular and Experimental Surgery, Clinic for General-, Visceral-, Vascular - and Transplant Surgery, Faculty of Medicine, Otto-von-Guericke University Magdeburg, 39120, Magdeburg, Germany
| | - Axel Boese
- INKA Health Tech Innovation Lab., Medical Faculty, Otto-von-Guericke University Magdeburg, 39120, Magdeburg, Germany
| | - Ulf D Kahlert
- Molecular and Experimental Surgery, Clinic for General-, Visceral-, Vascular - and Transplant Surgery, Faculty of Medicine, Otto-von-Guericke University Magdeburg, 39120, Magdeburg, Germany
- Research Campus STIMULATE, Otto-von-Guericke University Magdeburg, 39120, Magdeburg, Germany
| | - Igor Fischer
- Department of Neurosurgery, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, 40225, Düsseldorf, Germany.
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4
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Hertler C, Felsberg J, Gramatzki D, Le Rhun E, Clarke J, Soffietti R, Wick W, Chinot O, Ducray F, Roth P, McDonald K, Hau P, Hottinger AF, Reijneveld J, Schnell O, Marosi C, Glantz M, Darlix A, Lombardi G, Krex D, Glas M, Reardon DA, van den Bent M, Lefranc F, Herrlinger U, Razis E, Carpentier AF, Phillips S, Rudà R, Wick A, Tabouret E, Meyronet D, Maurage CA, Rushing E, Rapkins R, Bumes E, Hegi M, Weyerbrock A, Aregawi D, Gonzalez-Gomez C, Pellerino A, Klein M, Preusser M, Bendszus M, Golfinopoulos V, von Deimling A, Gorlia T, Wen PY, Reifenberger G, Weller M. Long-term survival with IDH wildtype glioblastoma: first results from the ETERNITY Brain Tumor Funders' Collaborative Consortium (EORTC 1419). Eur J Cancer 2023; 189:112913. [PMID: 37277265 DOI: 10.1016/j.ejca.2023.05.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 05/03/2023] [Indexed: 06/07/2023]
Abstract
BACKGROUND Median survival with glioblastoma remains in the range of 12 months on population levels. Only few patients survive for more than 5 years. Patient and disease features associated with long-term survival remain poorly defined. METHODS European Organization for Research and Treatment of Cancer (EORTC) 1419 (ETERNITY) is a registry study supported by the Brain Tumor Funders Collaborative in the US and the EORTC Brain Tumor Group. Patients with glioblastoma surviving at least 5 years from diagnosis were identified at 24 sites in Europe, US, and Australia. In patients with isocitrate dehydrogenase (IDH) wildtype tumours, prognostic factors were analysed using the Kaplan-Meier method and the Cox proportional hazards model. A population-based reference cohort was obtained from the Cantonal cancer registry Zurich. RESULTS At the database lock of July 2020, 280 patients with histologically centrally confirmed glioblastoma (189 IDH wildtype, 80 IDH mutant, 11 incompletely characterised) had been registered. In the IDH wildtype population, median age was 56 years (range 24-78 years), 96 patients (50.8%) were female, 139 patients (74.3%) had tumours with O6-methylguanine DNA methyltransferase (MGMT) promoter methylation. Median overall survival was 9.9 years (95% confidence interval [95% CI] 7.9-11.9). Patients without recurrence experienced longer median survival (not reached) than patients with one or more recurrences (8.92 years) (p < 0.001) and had a high rate (48.8%) of MGMT promoter-unmethylated tumours. CONCLUSIONS Freedom from progression is a powerful predictor of overall survival in long-term survivors with glioblastoma. Patients without relapse often have MGMT promoter-unmethylated glioblastoma and may represent a distinct subtype of glioblastoma.
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Affiliation(s)
- Caroline Hertler
- Department of Neurology, University Hospital and University of Zurich, Zurich, Switzerland; Clinical Neuroscience Center, University Hospital and University of Zurich, Zurich, Switzerland
| | - Jörg Felsberg
- Institute of Neuropathology, Medical Faculty, Heinrich Heine University and University Hospital Düsseldorf, Düsseldorf, Germany
| | - Dorothee Gramatzki
- Department of Neurology, University Hospital and University of Zurich, Zurich, Switzerland; Clinical Neuroscience Center, University Hospital and University of Zurich, Zurich, Switzerland
| | - Emilie Le Rhun
- Department of Neurology, University Hospital and University of Zurich, Zurich, Switzerland; Clinical Neuroscience Center, University Hospital and University of Zurich, Zurich, Switzerland; Service de neurochirurgie, CHU Lille, F-59000 Lille, France; Univ. Lille, Inserm, CHU Lille, U1192, Laboratoire Protéomique, Réponse Inflammatoire et Spectrométrie de Masse (PRISM), Lille, France
| | - Jennifer Clarke
- UCSF Department of Neurological Surgery, Division of Neuro-Oncology, 400 Parnassus Avenue, A-808 San Francisco, CA, USA
| | - Riccardo Soffietti
- Division of Neuro-Oncology, Department of Neuroscience, University and City of Health and Science Hospital, Turin, Italy
| | - Wolfgang Wick
- Neurology Clinic, University of Heidelberg, Heidelberg, Germany; CCU Neurooncology, DKFZ, Heidelberg, Germany
| | - Olivier Chinot
- Aix-Marseille Univ, APHM, CNRS, INP, Inst Neurophysiopathol, CHU Timone, Service de Neuro-Oncologie, Marseille, France
| | - François Ducray
- Departments of Neuro-Oncology, Hospices Civils de Lyon, Centre de recherche en Cancérologie de Lyon, Lyon, France; INSERM U1052, CNRS UMR 5286, Université Lyon 1, Lyon, France
| | - Patrick Roth
- Department of Neurology, University Hospital and University of Zurich, Zurich, Switzerland; Clinical Neuroscience Center, University Hospital and University of Zurich, Zurich, Switzerland
| | - Kerrie McDonald
- Cure Brain Cancer Neuro-Oncology group, Lowy Cancer Research Centre, University of New South Wales, Sydney, Australia
| | - Peter Hau
- Department of Neurology and Wilhelm Sander-NeuroOncology Unit, University Hospital Regensburg, Regensburg, Germany
| | - Andreas F Hottinger
- Lundin Family Brain Tumor Center, Departments of Oncology & Clinical Neurosciences, CHUV Lausanne University Hospital, Lausanne, Switzerland
| | - Jaap Reijneveld
- Amsterdam UMC location Vrije Universiteit Amsterdam, Neurology, Brain Tumor Center Amsterdam, Amsterdam, the Netherlands; Department of Neurology, Stichting Epilepsie Instellingen Nederland, Heemstede, the Netherlands
| | - Oliver Schnell
- Department of Neurosurgery, Medical Center- University of Freiburg, Freiburg, Germany
| | - Christine Marosi
- Division of Oncology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Michael Glantz
- Departments of Neurosurgery and Oncology, Penn State College of Medicine - Hershey Medical Center, Hershey, PA, USA
| | - Amélie Darlix
- Department of Medical Oncology, Institut régional du Cancer de Montpellier, University of Montpellier, Montpellier, France; Institut de Génomique Fonctionnelle, INSERM, CNRS, University of Montpellier, Montpellier, France
| | - Giuseppe Lombardi
- Department of Oncology, Oncology 1, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata 64, 35128 Padua, Italy
| | - Dietmar Krex
- Department of Neurosurgery, University Hospital Carl Gustav Carus, TU, Dresden, Germany; German Cancer Consortium (DKTK), Partner Site Dresden, Germany
| | - Martin Glas
- Division of Clinical Neurooncology, Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Medicine Essen, University Duisburg-Essen, Essen, Germany; German Cancer Consortium (DKTK), Partner Site University Medicine Essen, Essen, Germany
| | - David A Reardon
- Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, USA; Harvard Medical School, Boston, USA
| | - Martin van den Bent
- Brain Tumor Center at ErasmusMC Cancer Institute, Erasmus University Hospital Rotterdam, Rotterdam, the Netherlands
| | - Florence Lefranc
- Department of Neurosurgery, Hôpital Universitaire de Bruxelles HUB, Brussels, Belgium
| | - Ulrich Herrlinger
- Division of Clinical Neurooncology, Department of Neurology and Center of Integrated Oncology, University of Bonn, Bonn, Germany
| | | | - Antoine F Carpentier
- Department of Neurology, Hôpital Saint-Louis, Université Paris Cité, APHP, Paris, France
| | - Samuel Phillips
- UCSF Department of Neurological Surgery, Division of Neuro-Oncology, 400 Parnassus Avenue, A-808 San Francisco, CA, USA
| | - Roberta Rudà
- Division of Neuro-Oncology, Department of Neuroscience, University and City of Health and Science Hospital, Turin, Italy
| | - Antje Wick
- Neurology Clinic, University of Heidelberg, Heidelberg, Germany
| | - Emeline Tabouret
- Aix-Marseille Univ, APHM, CNRS, INP, Inst Neurophysiopathol, CHU Timone, Service de Neuro-Oncologie, Marseille, France
| | - David Meyronet
- INSERM U1052, CNRS UMR 5286, Université Lyon 1, Lyon, France; Neuropathology, Hospices Civils de Lyon, Centre de recherche en Cancérologie de Lyon, Lyon, France
| | | | - Elisabeth Rushing
- Department of Neuropathology, University Hospital Zurich, Zurich, Switzerland
| | - Robert Rapkins
- Cure Brain Cancer Neuro-Oncology group, Lowy Cancer Research Centre, University of New South Wales, Sydney, Australia
| | - Elisabeth Bumes
- Department of Neurology and Wilhelm Sander-NeuroOncology Unit, University Hospital Regensburg, Regensburg, Germany
| | - Monika Hegi
- Neuroscience Research Center and Service of Neurosurgery & Lundin Family Brain Tumor Center, Lausanne University Hospital and University of Lausanne, 1066 Epalinges, Switzerland
| | - Astrid Weyerbrock
- Department of Neurology, Stichting Epilepsie Instellingen Nederland, Heemstede, the Netherlands
| | - Dawit Aregawi
- Departments of Neurosurgery and Oncology, Penn State College of Medicine - Hershey Medical Center, Hershey, PA, USA
| | - Christian Gonzalez-Gomez
- UCSF Department of Neurological Surgery, Division of Neuro-Oncology, 400 Parnassus Avenue, A-808 San Francisco, CA, USA
| | - Alessia Pellerino
- Division of Neuro-Oncology, Department of Neuroscience, University and City of Health and Science Hospital, Turin, Italy
| | - Martin Klein
- Amsterdam UMC location Vrije Universiteit Amsterdam, Medical Psychology, Amsterdam, the Netherlands
| | - Matthias Preusser
- Division of Oncology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Martin Bendszus
- Department of Neuroradiology, University Hospital of Heidelberg, Heidelberg, Germany
| | | | - Andreas von Deimling
- Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany; CCU Neuropathology, German Cancer Center (DKFZ), Heidelberg, Germany
| | | | - Patrick Y Wen
- Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, USA; Harvard Medical School, Boston, USA
| | - Guido Reifenberger
- Institute of Neuropathology, Medical Faculty, Heinrich Heine University and University Hospital Düsseldorf, Düsseldorf, Germany; German Cancer Consortium (DKTK), partner site Essen/Düsseldorf, Düsseldorf, Germany
| | - Michael Weller
- Department of Neurology, University Hospital and University of Zurich, Zurich, Switzerland; Clinical Neuroscience Center, University Hospital and University of Zurich, Zurich, Switzerland.
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5
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Assessing Metabolic Markers in Glioblastoma Using Machine Learning: A Systematic Review. Metabolites 2023; 13:metabo13020161. [PMID: 36837779 PMCID: PMC9958885 DOI: 10.3390/metabo13020161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 01/14/2023] [Accepted: 01/18/2023] [Indexed: 01/24/2023] Open
Abstract
Glioblastoma (GBM) is a common and deadly brain tumor with late diagnoses and poor prognoses. Machine learning (ML) is an emerging tool that can create highly accurate diagnostic and prognostic prediction models. This paper aimed to systematically search the literature on ML for GBM metabolism and assess recent advancements. A literature search was performed using predetermined search terms. Articles describing the use of an ML algorithm for GBM metabolism were included. Ten studies met the inclusion criteria for analysis: diagnostic (n = 3, 30%), prognostic (n = 6, 60%), or both (n = 1, 10%). Most studies analyzed data from multiple databases, while 50% (n = 5) included additional original samples. At least 2536 data samples were run through an ML algorithm. Twenty-seven ML algorithms were recorded with a mean of 2.8 algorithms per study. Algorithms were supervised (n = 24, 89%), unsupervised (n = 3, 11%), continuous (n = 19, 70%), or categorical (n = 8, 30%). The mean reported accuracy and AUC of ROC were 95.63% and 0.779, respectively. One hundred six metabolic markers were identified, but only EMP3 was reported in multiple studies. Many studies have identified potential biomarkers for GBM diagnosis and prognostication. These algorithms show promise; however, a consensus on even a handful of biomarkers has not yet been made.
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6
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Nagy DG, Fedorcsák I, Bagó AG, Gáti G, Martos J, Szabó P, Rajnai H, Kenessey I, Borbély K. Therapy Defining at Initial Diagnosis of Primary Brain Tumor-The Role of 18F-FET PET/CT and MRI. Biomedicines 2023; 11:biomedicines11010128. [PMID: 36672636 PMCID: PMC9855996 DOI: 10.3390/biomedicines11010128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 12/19/2022] [Accepted: 12/28/2022] [Indexed: 01/06/2023] Open
Abstract
Primary malignant brain tumors are heterogeneous and infrequent neoplasms. Their classification, therapeutic regimen and prognosis have undergone significant development requiring the innovation of an imaging diagnostic. The performance of enhanced magnetic resonance imaging depends on blood-brain barrier function. Several studies have demonstrated the advantages of static and dynamic amino acid PET/CT providing accurate metabolic status in the neurooncological setting. The aim of our single-center retrospective study was to test the primary diagnostic role of amino acid PET/CT compared to enhanced MRI. Emphasis was placed on cases prior to intervention, therefore, a certain natural bias was inevitable. In our analysis for newly found brain tumors 18F-FET PET/CT outperformed contrast MRI and PWI in terms of sensitivity and negative predictive value (100% vs. 52.9% and 36.36%; 100% vs. 38.46% and 41.67%), in terms of positive predictive value their performance was roughly the same (84.21 % vs. 90% and 100%), whereas regarding specificity contrast MRI and PWI were superior (40% vs. 83.33% and 100%). Based on these results the superiority of 18F-FET PET/CT seems to present incremental value during the initial diagnosis. In the case of non-enhancing tumors, it should always be suggested as a therapy-determining test.
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Affiliation(s)
- Dávid Gergő Nagy
- National Institute of Mental Health, Neurology and Neurosurgery, 1145 Budapest, Hungary
| | - Imre Fedorcsák
- National Institute of Mental Health, Neurology and Neurosurgery, 1145 Budapest, Hungary
| | - Attila György Bagó
- National Institute of Mental Health, Neurology and Neurosurgery, 1145 Budapest, Hungary
| | - Georgina Gáti
- National Institute of Mental Health, Neurology and Neurosurgery, 1145 Budapest, Hungary
| | - János Martos
- National Institute of Mental Health, Neurology and Neurosurgery, 1145 Budapest, Hungary
| | | | - Hajnalka Rajnai
- Department of Pathology and Experimental Cancer Research, Semmelweis University, 1085 Budapest, Hungary
| | - István Kenessey
- National Cancer Registry, National Institute of Oncology, 1122 Budapest, Hungary
- Pathology, Forensic and Insurance Medicine, Semmelweis University, 1091 Budapest, Hungary
- Correspondence:
| | - Katalin Borbély
- PET/CT Outpatient Department, National Institute of Oncology, 1122 Budapest, Hungary
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7
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Richardson TE, Walker JM, Abdullah KG, McBrayer SK, Viapiano MS, Mussa ZM, Tsankova NM, Snuderl M, Hatanpaa KJ. Chromosomal instability in adult-type diffuse gliomas. Acta Neuropathol Commun 2022; 10:115. [PMID: 35978439 PMCID: PMC9386991 DOI: 10.1186/s40478-022-01420-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 08/04/2022] [Indexed: 11/14/2022] Open
Abstract
Chromosomal instability (CIN) is a fundamental property of cancer and a key underlying mechanism of tumorigenesis and malignant progression, and has been documented in a wide variety of cancers, including colorectal carcinoma with mutations in genes such as APC. Recent reports have demonstrated that CIN, driven in part by mutations in genes maintaining overall genomic stability, is found in subsets of adult-type diffusely infiltrating gliomas of all histologic and molecular grades, with resulting elevated overall copy number burden, chromothripsis, and poor clinical outcome. Still, relatively few studies have examined the effect of this process, due in part to the difficulty of routinely measuring CIN clinically. Herein, we review the underlying mechanisms of CIN, the relationship between chromosomal instability and malignancy, the prognostic significance and treatment potential in various cancers, systemic disease, and more specifically, in diffusely infiltrating glioma subtypes. While still in the early stages of discovery compared to other solid tumor types in which CIN is a known driver of malignancy, the presence of CIN as an early factor in gliomas may in part explain the ability of these tumors to develop resistance to standard therapy, while also providing a potential molecular target for future therapies.
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Affiliation(s)
- Timothy E. Richardson
- Department of Pathology, Molecular, and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, Annenberg Building, 15th Floor, 1468 Madison Avenue, New York, NY 10029 USA
| | - Jamie M. Walker
- Department of Pathology, Molecular, and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, Annenberg Building, 15th Floor, 1468 Madison Avenue, New York, NY 10029 USA
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029 USA
| | - Kalil G. Abdullah
- Department of Neurosurgery, University of Pittsburgh School of Medicine, 200 Lothrop St, Pittsburgh, PA 15213 USA
- Hillman Comprehensive Cancer Center, University of Pittsburgh Medical Center, 5115 Centre Ave, Pittsburgh, PA 15232 USA
| | - Samuel K. McBrayer
- Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX 75390 USA
- Children’s Medical Center Research Institute, University of Texas Southwestern Medical Center, Dallas, TX 75390 USA
| | - Mariano S. Viapiano
- Department of Neuroscience and Physiology, State University of New York, Upstate Medical University, Syracuse, NY 13210 USA
- Department of Neurosurgery, State University of New York, Upstate Medical University, Syracuse, NY 13210 USA
| | - Zarmeen M. Mussa
- Department of Pathology, Molecular, and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, Annenberg Building, 15th Floor, 1468 Madison Avenue, New York, NY 10029 USA
| | - Nadejda M. Tsankova
- Department of Pathology, Molecular, and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, Annenberg Building, 15th Floor, 1468 Madison Avenue, New York, NY 10029 USA
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029 USA
| | - Matija Snuderl
- Department of Pathology, New York University Langone Health, New York City, NY 10016 USA
| | - Kimmo J. Hatanpaa
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX 75390 USA
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8
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Kopecka J, Riganti C. Overcoming drug resistance in glioblastoma: new options in sight? CANCER DRUG RESISTANCE (ALHAMBRA, CALIF.) 2022; 4:512-516. [PMID: 35582029 PMCID: PMC9019268 DOI: 10.20517/cdr.2021.03] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 01/05/2021] [Indexed: 12/22/2022]
Affiliation(s)
- Joanna Kopecka
- Department of Oncology, University of Torino, Torino 10126, Italy
| | - Chiara Riganti
- Department of Oncology, University of Torino, Torino 10126, Italy
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9
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Gatto L, Di Nunno V, Franceschi E, Tosoni A, Bartolini S, Brandes AA. Pharmacotherapeutic Treatment of Glioblastoma: Where Are We to Date? Drugs 2022; 82:491-510. [PMID: 35397073 DOI: 10.1007/s40265-022-01702-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2022] [Indexed: 12/30/2022]
Abstract
The clinical management of glioblastoma (GBM) is still bereft of treatments able to significantly improve the poor prognosis of the disease. Despite the extreme clinical need for novel therapeutic drugs, only a small percentage of patients with GBM benefit from inclusion in a clinical trial. Moreover, often clinical studies do not lead to final interpretable conclusions. From the mistakes and negative results obtained in the last years, we are now able to plan a novel generation of clinical studies for patients with GBM, allowing the testing of multiple anticancer agents at the same time. This assumes critical importance, considering that, thanks to improved knowledge of altered molecular mechanisms related to the disease, we are now able to propose several potential effective compounds in patients with both newly diagnosed and recurrent GBM. Among the novel compounds assessed, the initially great enthusiasm toward trials employing immune checkpoint inhibitors (ICIs) was disappointing due to the negative results that emerged in three randomized phase III trials. However, novel biological insights into the disease suggest that immunotherapy can be a convincing and effective treatment in GBM even if ICIs failed to prolong the survival of these patients. In this regard, the most promising approach consists of engineered immune cells such as chimeric antigen receptor (CAR) T, CAR M, and CAR NK alone or in combination with other treatments. In this review, we discuss several issues related to systemic treatments in GBM patients. First, we assess critical issues toward the planning of clinical trials and the strategies employed to overcome these obstacles. We then move on to the most relevant interventional studies carried out on patients with previously untreated (newly diagnosed) GBM and those with recurrent and pretreated disease. Finally, we investigate novel immunotherapeutic approaches with special emphasis on preclinical and clinical data related to the administration of engineered immune cells in GBM.
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Affiliation(s)
- Lidia Gatto
- Department of Oncology, AUSL Bologna, Bologna, Italy
| | | | - Enrico Franceschi
- Nervous System Medical Oncology Department, IRCCS Istituto delle Scienze Neurologiche di Bologna, Via Altura 3, Bologna, Italy.
| | - Alicia Tosoni
- Nervous System Medical Oncology Department, IRCCS Istituto delle Scienze Neurologiche di Bologna, Via Altura 3, Bologna, Italy
| | - Stefania Bartolini
- Nervous System Medical Oncology Department, IRCCS Istituto delle Scienze Neurologiche di Bologna, Via Altura 3, Bologna, Italy
| | - Alba Ariela Brandes
- Nervous System Medical Oncology Department, IRCCS Istituto delle Scienze Neurologiche di Bologna, Via Altura 3, Bologna, Italy
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10
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A Genome-Wide Profiling of Glioma Patients with an IDH1 Mutation Using the Catalogue of Somatic Mutations in Cancer Database. Cancers (Basel) 2021; 13:cancers13174299. [PMID: 34503108 PMCID: PMC8428353 DOI: 10.3390/cancers13174299] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 08/20/2021] [Accepted: 08/21/2021] [Indexed: 02/08/2023] Open
Abstract
Simple Summary Glioma patients that present a somatic mutation in the isocitrate dehydrogenase 1 (IDH1) gene have a significantly better prognosis and overall survival than patients with the wild-type genotype. An IDH1 mutation is hypothesized to occur early during cellular transformation and leads to further genetic instability. A genome-wide profiling of glioma patients in the Catalogue of Somatic Mutations in Cancer (COSMIC) database was performed to classify the genetic differences in IDH1-mutant versus IDH1-wildtype patients. This classification will aid in a better understanding of how this specific mutation influences the genetic make-up of glioma and the resulting prognosis. Key differences in co-mutation and gene expression levels were identified that correlate with an improved prognosis. Abstract Gliomas are differentiated into two major disease subtypes, astrocytoma or oligodendroglioma, which are then characterized as either IDH (isocitrate dehydrogenase)-wild type or IDH-mutant due to the dramatic differences in prognosis and overall survival. Here, we investigated the genetic background of IDH1-mutant gliomas using the Catalogue of Somatic Mutations in Cancer (COSMIC) database. In astrocytoma patients, we found that IDH1 is often co-mutated with TP53, ATRX, AMBRA1, PREX1, and NOTCH1, but not CHEK2, EGFR, PTEN, or the zinc finger transcription factor ZNF429. The majority of the mutations observed in these genes were further confirmed to be either drivers or pathogenic by the Cancer-Related Analysis of Variants Toolkit (CRAVAT). Gene expression analysis showed down-regulation of DRG2 and MSN expression, both of which promote cell proliferation and invasion. There was also significant over-expression of genes such as NDRG3 and KCNB1 in IDH1-mutant astrocytoma patients. We conclude that IDH1-mutant glioma is characterized by significant genetic changes that could contribute to a better prognosis in glioma patients.
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Di Nunno V, Franceschi E, Tosoni A, Gatto L, Lodi R, Bartolini S, Brandes AA. Glioblastoma: Emerging Treatments and Novel Trial Designs. Cancers (Basel) 2021; 13:cancers13153750. [PMID: 34359651 PMCID: PMC8345198 DOI: 10.3390/cancers13153750] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 07/19/2021] [Accepted: 07/21/2021] [Indexed: 12/11/2022] Open
Abstract
Simple Summary Nowadays, very few systemic agents have shown clinical activity in patients with glioblastoma, making the research of novel therapeutic approaches a critical issue. Fortunately, the availability of novel compounds is increasing thanks to better biological knowledge of the disease. In this review we want to investigate more promising ongoing clinical trials in both primary and recurrent GBM. Furthermore, a great interest of the present work is focused on novel trial design strategies. Abstract Management of glioblastoma is a clinical challenge since very few systemic treatments have shown clinical efficacy in recurrent disease. Thanks to an increased knowledge of the biological and molecular mechanisms related to disease progression and growth, promising novel treatment strategies are emerging. The expanding availability of innovative compounds requires the design of a new generation of clinical trials, testing experimental compounds in a short time and tailoring the sample cohort based on molecular and clinical behaviors. In this review, we focused our attention on the assessment of promising novel treatment approaches, discussing novel trial design and possible future fields of development in this setting.
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Affiliation(s)
- Vincenzo Di Nunno
- Department of Oncology, AUSL Bologna, Via Altura 3, 40139 Bologna, Italy; (E.F.); (A.T.); (L.G.); (S.B.); (A.A.B.)
- Correspondence: ; Tel.: +39-0516225697
| | - Enrico Franceschi
- Department of Oncology, AUSL Bologna, Via Altura 3, 40139 Bologna, Italy; (E.F.); (A.T.); (L.G.); (S.B.); (A.A.B.)
| | - Alicia Tosoni
- Department of Oncology, AUSL Bologna, Via Altura 3, 40139 Bologna, Italy; (E.F.); (A.T.); (L.G.); (S.B.); (A.A.B.)
| | - Lidia Gatto
- Department of Oncology, AUSL Bologna, Via Altura 3, 40139 Bologna, Italy; (E.F.); (A.T.); (L.G.); (S.B.); (A.A.B.)
| | - Raffaele Lodi
- Istituto delle Scienze Neurologiche di Bologna, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 40139 Bologna, Italy;
| | - Stefania Bartolini
- Department of Oncology, AUSL Bologna, Via Altura 3, 40139 Bologna, Italy; (E.F.); (A.T.); (L.G.); (S.B.); (A.A.B.)
| | - Alba Ariela Brandes
- Department of Oncology, AUSL Bologna, Via Altura 3, 40139 Bologna, Italy; (E.F.); (A.T.); (L.G.); (S.B.); (A.A.B.)
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12
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Wang J, Xia X, Tao X, Zhao P, Deng C. Knockdown of carbohydrate sulfotransferase 12 decreases the proliferation and mobility of glioblastoma cells via the WNT/β-catenin pathway. Bioengineered 2021; 12:3934-3946. [PMID: 34288811 PMCID: PMC8806823 DOI: 10.1080/21655979.2021.1944455] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Glioblastoma (GBM) is a common malignant tumor of the brain. Members of the carbohydrate sulfotransferase (CHST) family are deregulated in various cancer types. However, limited data are available on the role of the members of the CHST family in the development of GBM. The present study aimed to identify the role of significant members of the CHST family in GBM and explore the effects and molecular mechanisms of these significant members on GBM cell proliferation and mobility. In the current study, we demonstrated that CHST12 is the only member of CHST family that is upregulated in GBM tissues and associated with a lower survival rate according to the data obtained from The Cancer Genome Atlas. Similarly, the expression of CHST12 increased in GBM tissues than in adjacent tissues and had an important diagnostic value in distinguishing tumor tissues from adjacent tissues. The high expression of CHST12 indicated a lower overall survival rate, was negatively associated with the Karnofsky Performance Scale score, was positively associated with the KI67 expression rate, and was an independent risk factor for GBM. Knockdown of CHST12 significantly decreased GBM cell proliferation and mobility and inhibited the Wnt/β-catenin pathway. Restoration of β-catenin expression in GBM cells reversed the inhibitory effects of CHST12 knockdown on GBM cell proliferation and mobility. In conclusion, the present study demonstrated that CHST12 may be a novel biomarker for GBM; it regulates GBM cell proliferation and mobility via the WNT/β-catenin pathway.
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Affiliation(s)
- Juan Wang
- Department of Neurology, Changle People's Hospital, Weifang Shandong, China
| | - Xiaoning Xia
- Department of Neurology, Changle People's Hospital, Weifang Shandong, China
| | - Xiuqin Tao
- Department of Neurology, Changle People's Hospital, Weifang Shandong, China
| | - Pingping Zhao
- Department of Oncology, Changle People's Hospital, Weifang Shandong, China
| | - Chuanyu Deng
- Department of Neurology, Changle People's Hospital, Weifang Shandong, China
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Lyon JF, Vasudevaraja V, Mirchia K, Walker JM, Corona RJ, Chin LS, Tran I, Snuderl M, Richardson TE, Viapiano MS. Spatial progression and molecular heterogeneity of IDH-mutant glioblastoma determined by DNA methylation-based mapping. Acta Neuropathol Commun 2021; 9:120. [PMID: 34193272 PMCID: PMC8243907 DOI: 10.1186/s40478-021-01221-7] [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: 05/01/2021] [Accepted: 06/19/2021] [Indexed: 01/16/2023] Open
Abstract
Glioblastoma (GBM) is the most common malignant primary central nervous system (CNS) neoplasm in adults, and has an almost universally poor prognosis. Recently, an emphasis on genetic and epigenetic profiling has revealed a number of molecular features useful in the diagnostic and prognostic classification of GBM, advancing our understanding of the underlying features that make these tumors so aggressive and providing the rationale for the creation of better targeted therapeutics. One such method, DNA methylation profiling, has recently emerged as an important technique for the classification of CNS tumors, with diagnostic accuracy in some cases surpassing traditional methods. However, how DNA methylation profiles change with the course of the disease remains less understood. Here, we present a case of a 30-year-old male with primary IDH-mutant GBM with widespread recurrence and death two years later. Using unsupervised hierarchical clustering of methylation probes, we created a phylogenetic map to trace the tumor path as it spread from the initial biopsy site throughout the right hemisphere, across the corpus callosum to the contralateral hemisphere, and into the brainstem. We identified molecular divergence between the right and left hemisphere GBM samples marked by distinct copy number profile alterations, alterations in specific methylation sites, and regional loss of MGMT promoter methylation, providing a potential mechanism for treatment resistance in this case. In summary, this case both highlights the molecular diversity in GBM, and illustrates a novel use for methylation profiling in establishing a phylogenetic profile to allow for spatial mapping of tumor progression.
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