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Weller M, Felsberg J, Hentschel B, Gramatzki D, Kubon N, Wolter M, Reusche M, Roth P, Krex D, Herrlinger U, Westphal M, Tonn JC, Regli L, Maurage CA, von Deimling A, Pietsch T, Le Rhun E, Reifenberger G. Improved prognostic stratification of patients with isocitrate dehydrogenase-mutant astrocytoma. Acta Neuropathol 2024; 147:11. [PMID: 38183430 PMCID: PMC10771615 DOI: 10.1007/s00401-023-02662-1] [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: 09/16/2023] [Revised: 11/19/2023] [Accepted: 11/20/2023] [Indexed: 01/08/2024]
Abstract
Prognostic factors and standards of care for astrocytoma, isocitrate dehydrogenase (IDH)-mutant, CNS WHO grade 4, remain poorly defined. Here we sought to explore disease characteristics, prognostic markers, and outcome in patients with this newly defined tumor type. We determined molecular biomarkers and assembled clinical and outcome data in patients with IDH-mutant astrocytomas confirmed by central pathology review. Patients were identified in the German Glioma Network cohort study; additional cohorts of patients with CNS WHO grade 4 tumors were identified retrospectively at two sites. In total, 258 patients with IDH-mutant astrocytomas (114 CNS WHO grade 2, 73 CNS WHO grade 3, 71 CNS WHO grade 4) were studied. The median age at diagnosis was similar for all grades. Karnofsky performance status at diagnosis inversely correlated with CNS WHO grade (p < 0.001). Despite more intensive treatment upfront with higher grade, CNS WHO grade was strongly prognostic: median overall survival was not reached for grade 2 (median follow-up 10.4 years), 8.1 years (95% CI 5.4-10.8) for grade 3, and 4.7 years (95% CI 3.4-6.0) for grade 4. Among patients with CNS WHO grade 4 astrocytoma, median overall survival was 5.5 years (95% CI 4.3-6.7) without (n = 58) versus 1.8 years (95% CI 0-4.1) with (n = 12) homozygous CDKN2A deletion. Lower levels of global DNA methylation as detected by LINE-1 methylation analysis were strongly associated with CNS WHO grade 4 (p < 0.001) and poor outcome. MGMT promoter methylation status was not prognostic for overall survival. Histomolecular stratification based on CNS WHO grade, LINE-1 methylation level, and CDKN2A status revealed four subgroups of patients with significantly different outcomes. In conclusion, CNS WHO grade, global DNA methylation status, and CDKN2A homozygous deletion are prognostic in patients with IDH-mutant astrocytoma. Combination of these parameters allows for improved prediction of outcome. These data aid in designing upcoming trials using IDH inhibitors.
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Affiliation(s)
- Michael Weller
- Department of Neurology, University Hospital Zurich, Frauenklinikstrasse 26, 8091, Zurich, Switzerland.
- Department of Neurology, University of Zurich, Zurich, Switzerland.
| | - Jörg Felsberg
- Institute of Neuropathology, Heinrich Heine University, Medical Faculty, and University Hospital Düsseldorf, Düsseldorf, Germany
| | - Bettina Hentschel
- Institute for Medical Informatics, Statistics and Epidemiology, University Leipzig, Leipzig, Germany
| | - Dorothee Gramatzki
- Department of Neurology, University Hospital Zurich, Frauenklinikstrasse 26, 8091, Zurich, Switzerland
| | - Nadezhda Kubon
- Institute of Neuropathology, Heinrich Heine University, Medical Faculty, and University Hospital Düsseldorf, Düsseldorf, Germany
| | - Marietta Wolter
- Institute of Neuropathology, Heinrich Heine University, Medical Faculty, and University Hospital Düsseldorf, Düsseldorf, Germany
| | - Matthias Reusche
- Institute for Medical Informatics, Statistics and Epidemiology, University Leipzig, Leipzig, Germany
| | - Patrick Roth
- Department of Neurology, University Hospital Zurich, Frauenklinikstrasse 26, 8091, Zurich, Switzerland
- Department of Neurology, University of Zurich, Zurich, Switzerland
| | - Dietmar Krex
- Faculty of Medicine, Department of Neurosurgery, Technische Universität Dresden, University Hospital Carl Gustav Carus, Dresden, Germany
| | | | - Manfred Westphal
- Department of Neurosurgery, University of Hamburg, Hamburg, Germany
| | - Joerg C Tonn
- Department of Neurosurgery, Ludwig-Maximilians-University Munich, Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
| | - Luca Regli
- Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland
- Department of Neurosurgery, University of Zurich, Zurich, Switzerland
| | - Claude-Alain Maurage
- Department of Pathology, Centre Biologie Pathologie, Lille University Hospital, Hopital Nord, Lille, France
| | - Andreas von Deimling
- Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany
- Clinical Cooperation Unit Neuropathology, German Cancer Center (DKFZ), and German Cancer Consortium (DKTK), Partner Site Heidelberg, Heidelberg, Germany
| | - Torsten Pietsch
- Department of Neuropathology, University of Bonn Medical Center, DGNN Brain Tumor Reference Center, Bonn, Germany
| | - Emilie Le Rhun
- Department of Neurology, University Hospital Zurich, Frauenklinikstrasse 26, 8091, Zurich, Switzerland
- Department of Neurology, University of Zurich, Zurich, Switzerland
- Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland
- Department of Neurosurgery, University of Zurich, Zurich, Switzerland
- Department of Neurosurgery, Lille University Hospital, Lille, France
| | - Guido Reifenberger
- Institute of Neuropathology, Heinrich Heine University, Medical Faculty, and University Hospital Düsseldorf, Düsseldorf, Germany
- German Cancer Consortium (DKTK), Partner Site Essen/Düsseldorf, Düsseldorf, Germany
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2
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Wang Y, Fushimi Y, Arakawa Y, Shimizu Y, Sano K, Sakata A, Nakajima S, Okuchi S, Hinoda T, Oshima S, Otani S, Ishimori T, Tanji M, Mineharu Y, Yoshida K, Nakamoto Y. Evaluation of isocitrate dehydrogenase mutation in 2021 world health organization classification grade 3 and 4 glioma adult-type diffuse gliomas with 18F-fluoromisonidazole PET. Jpn J Radiol 2023; 41:1255-1264. [PMID: 37219717 PMCID: PMC10613590 DOI: 10.1007/s11604-023-01450-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 05/15/2023] [Indexed: 05/24/2023]
Abstract
PURPOSE This study aimed to investigate the uptake characteristics of 18F-fluoromisonidazole (FMISO), in mutant-type isocitrate dehydrogenase (IDH-mutant, grade 3 and 4) and wild-type IDH (IDH-wildtype, grade 4) 2021 WHO classification adult-type diffuse gliomas. MATERIALS AND METHODS Patients with grade 3 and 4 adult-type diffuse gliomas (n = 35) were included in this prospective study. After registering 18F-FMISO PET and MR images, standardized uptake value (SUV) and apparent diffusion coefficient (ADC) were evaluated in hyperintense areas on fluid-attenuated inversion recovery (FLAIR) imaging (HIA), and in contrast-enhanced tumors (CET) by manually placing 3D volumes of interest. Relative SUVmax (rSUVmax) and SUVmean (rSUVmean), 10th percentile of ADC (ADC10pct), mean ADC (ADCmean) were measured in HIA and CET, respectively. RESULTS rSUVmean in HIA and rSUVmean in CET were significantly higher in IDH-wildtype than in IDH-mutant (P = 0.0496 and 0.03, respectively). The combination of FMISO rSUVmean in HIA and ADC10pct in CET, that of rSUVmax and ADC10pct in CET, that of rSUVmean in HIA and ADCmean in CET, were able to differentiate IDH-mutant from IDH-wildtype (AUC 0.80). When confined to astrocytic tumors except for oligodendroglioma, rSUVmax, rSUVmean in HIA and rSUVmean in CET were higher for IDH-wildtype than for IDH-mutant, but not significantly (P = 0.23, 0.13 and 0.14, respectively). The combination of FMISO rSUVmean in HIA and ADC10pct in CET was able to differentiate IDH-mutant (AUC 0.81). CONCLUSION PET using 18F-FMISO and ADC might provide a valuable tool for differentiating between IDH mutation status of 2021 WHO classification grade 3 and 4 adult-type diffuse gliomas.
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Affiliation(s)
- Yang Wang
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-Cho, Sakyo-Ku, Kyoto, 606-8507, Japan
| | - Yasutaka Fushimi
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-Cho, Sakyo-Ku, Kyoto, 606-8507, Japan.
| | - Yoshiki Arakawa
- Department of Neurosurgery, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan
| | - Yoichi Shimizu
- Division of Clinical Radiology Service, Kyoto University Hospital, Kyoto, 606-8507, Japan
| | - Kohei Sano
- Division of Clinical Radiology Service, Kyoto University Hospital, Kyoto, 606-8507, Japan
| | - Akihiko Sakata
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-Cho, Sakyo-Ku, Kyoto, 606-8507, Japan
| | - Satoshi Nakajima
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-Cho, Sakyo-Ku, Kyoto, 606-8507, Japan
| | - Sachi Okuchi
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-Cho, Sakyo-Ku, Kyoto, 606-8507, Japan
| | - Takuya Hinoda
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-Cho, Sakyo-Ku, Kyoto, 606-8507, Japan
| | - Sonoko Oshima
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-Cho, Sakyo-Ku, Kyoto, 606-8507, Japan
| | - Sayo Otani
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-Cho, Sakyo-Ku, Kyoto, 606-8507, Japan
| | - Takayoshi Ishimori
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-Cho, Sakyo-Ku, Kyoto, 606-8507, Japan
| | - Masahiro Tanji
- Department of Neurosurgery, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan
| | - Yohei Mineharu
- Department of Neurosurgery, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan
| | - Kazumichi Yoshida
- Department of Neurosurgery, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan
| | - Yuji Nakamoto
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-Cho, Sakyo-Ku, Kyoto, 606-8507, Japan
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Zhong Q, Luo D, Chen D, Li X, Du Q, Liang Q, Li J, Zhu X. The prognosis of gliomas with different molecular subtypes in the era of intensity-modulated radiation therapy (IMRT). Aging (Albany NY) 2023; 15:7781-7793. [PMID: 37556350 PMCID: PMC10457046 DOI: 10.18632/aging.204942] [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: 05/06/2023] [Accepted: 07/19/2023] [Indexed: 08/11/2023]
Abstract
PURPOSE This study aimed to evaluate the prognosis of glioma patients with different molecular subtypes of who treated with intensity-modulated radiation therapy (IMRT). METHODS We collected 45 glioma patients treated in our hospital between January 2017 and December 2020. All enrolled patients received postoperative IMRT and were divided into two groups based on the Isocitrate dehydrogenase (IDH status). Overall survival (OS) and progression-free survival (PFS) were estimated retrospectively. RESULTS The median follow-up was 22 months (range 2-108.5 months). The 1-year OS of IDH-mut group and ΙDH-wild group was similar (77.3% vs. 81.5%, p = 0.16). While the 1-year PFS of IDH-mut group was significantly higher than that in ΙDH-wild group (90.4% vs. 39.8%, p = 0.0051). Subgroup analysis revealed that the 1-year PFS of IDH-mut/1p/19q codeletion group and IDH-mut/1p/19q noncodeletion group was significantly higher than in IDH-wild type patients. For patients with IDH-mut/MGMT-methylation, the outcome was no significant difference in OS, but PFS was longer than other subtypes. CONCLUSION This retrospective study showed that 1-year PFS of patients with IDH mutated was better than IDH-wild type patients. In subgroups analysis, the outcomes were shown that patients with IDH-mut/ 1p/19q codeletion and patients with IDH-mut/1p/19q noncodeletion had longer 1-year PFS than IDH-wild type patients, but the OS was similar between the subgroups. Patients with IDH-mut/MGMT-methylation had the best prognosis in the whole subgroups. However, these results still need further confirmation of large sample size, prospectively, randomized controlled trails.
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Affiliation(s)
- Qiulu Zhong
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi 530000, P.R. China
- Department of Radiation Oncology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530000, P.R. China
| | - Danjing Luo
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi 530000, P.R. China
- Department of Radiation Oncology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530000, P.R. China
| | - Da Chen
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi 530000, P.R. China
| | - Xiangde Li
- Department of Radiation Oncology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530000, P.R. China
| | - Qinghua Du
- Department of Radiation Oncology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530000, P.R. China
| | - Qianfu Liang
- Department of Radiation Oncology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530000, P.R. China
| | - Jian Li
- Department of Radiation Oncology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530000, P.R. China
| | - Xiaodong Zhu
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi 530000, P.R. China
- Department of Oncology, Wuming Hospital of Guangxi Medical University, Nanning, Guangxi 530000, P.R. China
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Xie J, Lin Y, Li Y, Fang A, Li X, Wang S, Li W. lncRNA TRHDE-AS1 Correlated with Genomic Landscape and Clinical Outcome in Glioma. Genes (Basel) 2023; 14:genes14051052. [PMID: 37239411 DOI: 10.3390/genes14051052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 05/04/2023] [Accepted: 05/05/2023] [Indexed: 05/28/2023] Open
Abstract
The role of lncRNA in cancer development has received more and more attention in research. A variety of lncRNAs are associated with the occurrence and development of glioma. However, the role of TRHDE-AS1 in glioma is still unknown. In this study, we explored the role of TRHDE-AS1 in glioma through bioinformatic methods. We first identified an association between TRHDE-AS1 and tumor prognosis in pan-cancer analysis. Subsequently, the expression levels of TRHDE-AS1 in various clinical types of glioma were compared, and significant differences were found in pathological classification, WHO classification, molecular classification, IDH mutation, and age stratification. We analyzed the genes co-expressed with TRHDE-AS1 in glioma. In the functional analysis of TRHDE-AS1, we found that TRHDE-AS1 may be involved in the regulation of synapse-related functions. In glioma cancer driver gene correlation analysis, it was also found that TRHDE-AS1 was significantly correlated with the expression levels of multiple driver genes such as TP53, BRAF, and IDH1. By comparing the mutant profiles of the high and low TRHDE-AS1 groups, we also found that there may be differences in TP53 and CIC gene mutations in low-grade gliomas. Subsequent correlation analysis between TRHDE-AS1 and glioma immune microenvironment showed that the expression level of TRHDE-AS1 was correlated with a variety of immune cells. Therefore, we believe that TRHDE-AS1 is involved in the occurrence and development of glioma and has the ability to predict the prognosis of glioma as a biomarker of glioma.
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Affiliation(s)
- Jinxuan Xie
- School of Public Health, Capital Medical University, Beijing 100069, China
- National Institute for Data Science in Health and Medicine, Capital Medical University, Beijing 100069, China
| | - Yi Lin
- Department of Neuro-Oncology, Cancer Center, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| | - Yajie Li
- National Institute for Data Science in Health and Medicine, Capital Medical University, Beijing 100069, China
- Department of Neuro-Oncology, Cancer Center, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| | - Aizhong Fang
- National Institute for Data Science in Health and Medicine, Capital Medical University, Beijing 100069, China
- Department of Neuro-Oncology, Cancer Center, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| | - Xin Li
- School of Public Health, Capital Medical University, Beijing 100069, China
- National Institute for Data Science in Health and Medicine, Capital Medical University, Beijing 100069, China
| | - Songlin Wang
- Salivary Gland Disease Center and Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, School of Stomatology, Beijing Laboratory of Oral Health, Capital Medical University, Beijing 100050, China
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Capital Medical University, Beijing 100069, China
| | - Wenbin Li
- Department of Neuro-Oncology, Cancer Center, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
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Niu X, Pan Q, Zhang Q, Wang X, Liu Y, Li Y, Zhang Y, Yang Y, Mao Q. Weighted correlation network analysis identifies multiple susceptibility loci for low-grade glioma. Cancer Med 2023; 12:6379-6387. [PMID: 36305248 PMCID: PMC10028094 DOI: 10.1002/cam4.5368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 09/21/2022] [Accepted: 10/07/2022] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND The current molecular classifications cannot completely explain the polarized malignant biological behavior of low-grade gliomas (LGGs), especially for tumor recurrence. Therefore, we tried to identify suspicious hub genes related to tumor recurrence in LGGs. METHODS In this study, we constructed a gene-miRNA-lncRNA co-expression network for LGGs by a weighted gene co-expression network analysis (WGCNA). GDCRNATools and the WGCNA R package were mainly used in data analysis. RESULTS Sequencing data from 502 LGG patients were analyzed in this study. Compared with recurrent glioma tissues, we identified 774 differentially expressed (DE) mRNAs, 49 DE miRNAs, and 129 DE lncRNAs in primary LGGs and ultimately determined that the expression of MKLN1 was related to tumor recurrence in LGG. CONCLUSION This study identified the potential biomarkers for the pathogenesis and recurrence of LGGs and proposed that MKLN1 could be a potential therapeutic target.
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Affiliation(s)
- Xiaodong Niu
- Department of Neurosurgery and West China Glioma Center, West China Hospital, Sichuan University, Chengdu, China
| | - Qi Pan
- Department of Dermatology, Chongqing Hospital of Traditional Chinese Medicine, Chongqing, China
| | - Qianwen Zhang
- Department of out-patient, West China Hospital, Sichuan University, Chengdu, China
| | - Xiang Wang
- Department of Neurosurgery and West China Glioma Center, West China Hospital, Sichuan University, Chengdu, China
| | - Yanhui Liu
- Department of Neurosurgery and West China Glioma Center, West China Hospital, Sichuan University, Chengdu, China
| | - Yu Li
- Department of Anesthesia, West China Hospital, Sichuan University, Chengdu, China
| | - Yuekang Zhang
- Department of Neurosurgery and West China Glioma Center, West China Hospital, Sichuan University, Chengdu, China
| | - Yuan Yang
- Department of Neurosurgery and West China Glioma Center, West China Hospital, Sichuan University, Chengdu, China
| | - Qing Mao
- Department of Neurosurgery and West China Glioma Center, West China Hospital, Sichuan University, Chengdu, China
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Ozair A, Bhat V, Alisch RS, Khosla AA, Kotecha RR, Odia Y, McDermott MW, Ahluwalia MS. DNA Methylation and Histone Modification in Low-Grade Gliomas: Current Understanding and Potential Clinical Targets. Cancers (Basel) 2023; 15:cancers15041342. [PMID: 36831683 PMCID: PMC9954183 DOI: 10.3390/cancers15041342] [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: 12/21/2022] [Revised: 02/02/2023] [Accepted: 02/14/2023] [Indexed: 02/22/2023] Open
Abstract
Gliomas, the most common type of malignant primary brain tumor, were conventionally classified through WHO Grades I-IV (now 1-4), with low-grade gliomas being entities belonging to Grades 1 or 2. While the focus of the WHO Classification for Central Nervous System (CNS) tumors had historically been on histopathological attributes, the recently released fifth edition of the classification (WHO CNS5) characterizes brain tumors, including gliomas, using an integration of histological and molecular features, including their epigenetic changes such as histone methylation, DNA methylation, and histone acetylation, which are increasingly being used for the classification of low-grade gliomas. This review describes the current understanding of the role of DNA methylation, demethylation, and histone modification in pathogenesis, clinical behavior, and outcomes of brain tumors, in particular of low-grade gliomas. The review also highlights potential diagnostic and/or therapeutic targets in associated cellular biomolecules, structures, and processes. Targeting of MGMT promoter methylation, TET-hTDG-BER pathway, association of G-CIMP with key gene mutations, PARP inhibition, IDH and 2-HG-associated processes, TERT mutation and ARL9-associated pathways, DNA Methyltransferase (DNMT) inhibition, Histone Deacetylase (HDAC) inhibition, BET inhibition, CpG site DNA methylation signatures, along with others, present exciting avenues for translational research. This review also summarizes the current clinical trial landscape associated with the therapeutic utility of epigenetics in low-grade gliomas. Much of the evidence currently remains restricted to preclinical studies, warranting further investigation to demonstrate true clinical utility.
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Affiliation(s)
- Ahmad Ozair
- Miami Cancer Institute, Baptist Health South Florida, Miami, FL 33176, USA
- Faculty of Medicine, King George’s Medical University, Lucknow 226003, India
| | - Vivek Bhat
- St. John’s Medical College, Bangalore 560034, India
| | - Reid S. Alisch
- Department of Neurosurgery, University of Wisconsin-Madison, Madison, WI 53792, USA
| | - Atulya A. Khosla
- Miami Cancer Institute, Baptist Health South Florida, Miami, FL 33176, USA
| | - Rupesh R. Kotecha
- Miami Cancer Institute, Baptist Health South Florida, Miami, FL 33176, USA
- Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA
| | - Yazmin Odia
- Miami Cancer Institute, Baptist Health South Florida, Miami, FL 33176, USA
- Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA
| | - Michael W. McDermott
- Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA
- Miami Neuroscience Institute, Baptist Health South Florida, Miami, FL 33176, USA
- Correspondence: (M.W.M.); (M.S.A.)
| | - Manmeet S. Ahluwalia
- Miami Cancer Institute, Baptist Health South Florida, Miami, FL 33176, USA
- Miami Neuroscience Institute, Baptist Health South Florida, Miami, FL 33176, USA
- Correspondence: (M.W.M.); (M.S.A.)
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Ao L, Shi D, Liu D, Yu H, Xu L, Xia Y, Hao S, Yang Y, Zhong W, Zhou J, Xia H. A survival nomogram model constructed with common clinical characteristics to assist clinical decisions for diffuse low-grade gliomas: A population analysis based on SEER database. Front Oncol 2023; 13:963688. [PMID: 36845716 PMCID: PMC9947492 DOI: 10.3389/fonc.2023.963688] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 01/24/2023] [Indexed: 02/11/2023] Open
Abstract
Background The prognosis of diffuse low-grade gliomas (DLGGs, WHO grade 2) is highly variable, making it difficult to evaluate individual patient outcomes. In this study, we used common clinical characteristics to construct a predictive model with multiple indicators. Methods We identified 2459 patients diagnosed with astrocytoma and oligodendroglioma from 2000 to 2018 in the SEER database. After removing invalid information, we randomly divided the cleaned patient data into training and validation groups. We performed univariate and multivariate Cox regression analyses and constructed a nomogram. Receiver operating characteristic (ROC) curve, c-index, calibration curve, and subgroup analyses were used to assess the accuracy of the nomogram by internal and external validation. Results After univariate and multivariate Cox regression analyses, we identified seven independent prognostic factors, namely, age (P<0.001), sex (P<0.05), histological type (P<0.001), surgery (P<0.01), radiotherapy (P<0.001), chemotherapy (P<0.05) and tumor size (P<0.001). The ROC curve, c-index, calibration curve, and subgroup analyses of the training group and the validation group showed that the model had good predictive value. The nomogram for DLGGs predicted patients' 3-, 5- and 10-year survival rates based on these seven variables. Conclusions The nomogram constructed with common clinical characteristics has good prognostic value for patients with DLGGs and can help physicians make clinical decisions.
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Affiliation(s)
- Lei Ao
- Department of Neurosurgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Dongjie Shi
- Department of Neurosurgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Dan Liu
- Department of Neurosurgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hua Yu
- Department of Neurosurgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Li Xu
- Health Management Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yongzhi Xia
- Department of Neurosurgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Shilei Hao
- Key Laboratory of Biorheological Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing, China
| | - Yaying Yang
- Department of Pathology, Molecular Medicine and Tumor Center, Chongqing Medical University, Chongqing, China
| | - Wenjie Zhong
- Department of Neurosurgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Junjie Zhou
- Department of Pathology, Molecular Medicine and Tumor Center, Chongqing Medical University, Chongqing, China
| | - Haijian Xia
- Department of Neurosurgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China,*Correspondence: Haijian Xia,
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Slaghour RM, Almarshedi RA, Alzahrani AM, Albadr F. T2-Fluid-Attenuated Inversion Recovery (FLAIR) Mismatch as a Novel Specific MRI Marker for Adult Low-Grade Glioma (LGG): A Case Report. Cureus 2022; 14:e29457. [PMID: 36299937 PMCID: PMC9587756 DOI: 10.7759/cureus.29457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2022] [Indexed: 11/16/2022] Open
Abstract
Astrocytic tumors are primary central nervous system tumors. They are the most common tumors arising from glial cells. In the new WHO classification 2021, adult-type diffuse astrocytic gliomas subdivide into isocitrate dehydrogenase (IDH)-mutant astrocytoma, IDH-mutant and 1p/19q-codeleted oligodendroglioma, and IDH-wildtype glioblastoma. The T2-fluid-attenuated inversion recovery (FLAIR) mismatch sign describes the MRI appearance of IDH-mutant astrocytoma, it is considered a highly specific radiogenomic signature for diffuse astrocytoma, as opposed to other lower-grade. MRI is the first and most accurate diagnostic tool for low-grade gliomas (LGGs). It is particularly helpful in distinguishing a diffuse astrocytoma from an oligodendroglioma that will not demonstrate T2-FLAIR mismatch. The tumor displays a hyperintense signal on T2-weighted images and a hypointense signal on T2-weighted FLAIR images, which distinguishes it from other types of diffuse gliomas. We report a case of a 29-year-old female patient who was diagnosed with IDH-mutant 1p/19q-non-codeleted diffuse astrocytoma based on MRI T-2 FLAIR mismatch sign, which is confirmed by the molecular analysis in the pathology lab. Our aim of this report is to confirm the power of the MRI findings in the diagnosis of glioma genotypes and to assess neurosurgeons in the preoperative surgical planning.
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9
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Ruiz-Garcia H, Middlebrooks EH, Trifiletti DM, Chaichana KL, Quinones-Hinojosa A, Sheehan JP. The Extent of Resection in Gliomas-Evidence-Based Recommendations on Methodological Aspects of Research Design. World Neurosurg 2022; 161:382-395.e3. [PMID: 35505558 DOI: 10.1016/j.wneu.2021.08.140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 08/30/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Modern neurosurgery has established maximal safe resection as a cornerstone in the management of diffuse gliomas. Evaluation of the extent of resection (EOR), and its association with certain outcomes or interventions, heavily depends on an adequate methodology to draw strong conclusions. We aim to identify weaknesses and limitations that may threaten the internal validity and generalizability of studies involving the EOR in patients with glioma and to suggest methodological recommendations that may help mitigate these threats. METHODS A systematic search was performed by querying PubMed, Web of Science, and Scopus since inception to April 30, 2021 using PICOS/PRISMA guidelines. Articles were then screened to identify high-impact studies evaluating the EOR in patients diagnosed with diffuse gliomas in accordance with predefined criteria. We identify common weakness and limitations during the evaluation of the EOR in the selected studies and then delineate potential methodological recommendations for future endeavors dealing with the EOR. RESULTS We identified 31 high-impact studies and found several research design issues including inconsistencies regarding EOR terminology, measurement, data collection, analysis, and reporting. Although some of these issues were related to now outdated reporting standards, many were still present in recent publications and deserve attention in contemporary and future research. CONCLUSIONS There is a current need to focus more attention to the methodological aspects of glioma research. Methodological inconsistencies may introduce weaknesses into the internal validity of the studies and hamper comparative analysis of cohorts from different institutions. We hope our recommendations will eventually help develop stronger methodological designs in future research endeavors.
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Affiliation(s)
- Henry Ruiz-Garcia
- Department of Neurological Surgery, Mayo Clinic, Jacksonville, Florida, USA; Department of Radiation Oncology, Mayo Clinic, Jacksonville, Florida, USA; Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Jacksonville, Florida, USA
| | - Erik H Middlebrooks
- Department of Neurological Surgery, Mayo Clinic, Jacksonville, Florida, USA; Department of Radiology, Mayo Clinic, Jacksonville, Florida, USA
| | - Daniel M Trifiletti
- Department of Neurological Surgery, Mayo Clinic, Jacksonville, Florida, USA; Department of Radiation Oncology, Mayo Clinic, Jacksonville, Florida, USA
| | | | | | - Jason P Sheehan
- Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia, USA.
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10
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van Asperen JV, Robe PA, Hol EM. GFAP Alternative Splicing and the Relevance for Disease – A Focus on Diffuse Gliomas. ASN Neuro 2022; 14:17590914221102065. [PMID: 35673702 PMCID: PMC9185002 DOI: 10.1177/17590914221102065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Glial fibrillary acidic protein (GFAP) is an intermediate filament protein that is
characteristic for astrocytes and neural stem cells, and their malignant analogues in
glioma. Since the discovery of the protein 50 years ago, multiple alternative splice
variants of the GFAP gene have been discovered, leading to different GFAP isoforms. In
this review, we will describe GFAP isoform expression from gene to protein to network,
taking the canonical isoforms GFAPα and the main alternative variant GFAPδ as the starting
point. We will discuss the relevance of studying GFAP and its isoforms in disease, with a
specific focus on diffuse gliomas.
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Affiliation(s)
- Jessy V. van Asperen
- Department of Translational Neuroscience, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Pierre A.J.T. Robe
- Department of Neurology and Neurosurgery, University Medical Center Utrecht Brain Center, University Utrecht, Utrecht, The Netherlands
| | - Elly M. Hol
- Department of Translational Neuroscience, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
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11
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Malhotra AK, Karthikeyan V, Zabih V, Landry A, Bennett J, Bartels U, Nathan PC, Tabori U, Hawkins C, Das S, Gupta S. Adolescent and young adult glioma: systematic review of demographic, disease, and treatment influences on survival. Neurooncol Adv 2022; 4:vdac168. [PMID: 36479061 PMCID: PMC9721387 DOI: 10.1093/noajnl/vdac168] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/03/2023] Open
Abstract
BACKGROUND Prognostic factors in adolescent and young adult (AYA) glioma are not well understood. Though clinical and molecular differences between pediatric and adult glioma have been characterized, their application to AYA populations is less clear. There is a major need to develop more robust evidence-based practices for managing AYA glioma patients. METHODS A systematic review using PRISMA methodology was conducted using multiple databases with the objective of identifying demographic, clinical, molecular and treatment factors influencing AYA glioma outcomes. RESULTS 40 Studies met inclusion criteria. Overall survival was highly variable across studies depending on glioma grade, anatomic compartment and cohort characteristics. Thirty-five studies suffered from high risk of bias in at least one domain. Several studies included older adults within their cohorts; few captured purely AYA groups. Despite study heterogeneity, identified favorable prognosticators included younger age, higher functional status at diagnosis, low-grade pathology, oligodendroglioma histology and increased extent of surgical resection. Though isocitrate dehydrogenase (IDH) mutant status was associated with favorable prognosis, validity of this finding within AYA was compromised though may studies including older adults. The prognostic influence of chemotherapy and radiotherapy on overall survival varied across studies with conflicting evidence. CONCLUSION Existing literature is heterogenous, at high risk of bias, and rarely focused solely on AYA patients. Many included studies did not reflect updated pathological and molecular AYA glioma classification. The optimal role of chemotherapy, radiotherapy, and targeted agents cannot be determined from existing literature and should be the focus of future studies.
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Affiliation(s)
- Armaan K Malhotra
- Division of Neurosurgery, University of Toronto, Toronto, Ontario, Canada
| | | | - Veda Zabih
- Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Alexander Landry
- Division of Neurosurgery, University of Toronto, Toronto, Ontario, Canada
| | - Julie Bennett
- Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Ute Bartels
- Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Paul C Nathan
- Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Uri Tabori
- Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Cynthia Hawkins
- Division of Paediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Sunit Das
- Division of Neurosurgery, St. Michael’s Hospital, University of Toronto, Toronto, OntarioCanada
| | - Sumit Gupta
- Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
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12
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Patrick S, Gowda P, Lathoria K, Suri V, Sen E. YAP1-mediated regulation of mitochondrial dynamics in IDH1 mutant gliomas. J Cell Sci 2021; 134:273515. [PMID: 34651186 DOI: 10.1242/jcs.259188] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 10/07/2021] [Indexed: 11/20/2022] Open
Abstract
Mutation of the isocitrate dehydrogenase 1 (IDH1) gene leads to the production of oncometabolite D-2-hydroxyglutarate (2-HG) from α-ketoglutarate and is associated with better prognosis in glioma. As Yes-associated protein 1 (YAP1) is an important regulator of tumor progression, its role in glioma expressing IDH1 with an R132H mutation was investigated. Diminished nuclear levels of YAP1 in IDH1 mutant glioma tissues and cell lines were accompanied by decreased levels of mitochondrial transcription factor A (TFAM). Luciferase reporter assays and chromatin immunoprecipitation were used to investigate the functionality of the TEAD2-binding site on the TFAM promoter in mediating its YAP1-dependent expression. YAP1-dependent mitochondrial fragmentation and ROS generation were accompanied by decreased telomerase reverse transcriptase (TERT) levels and increased mitochondrial TERT localization in IDH1 R132H cells. Treatment with the Src kinase inhibitor bosutinib, which prevents extranuclear shuttling of TERT, further elevated ROS in IDH1 R132H cells and triggered apoptosis. Importantly, bosutinib treatment also increased ROS levels and induced apoptosis in IDH1 wild-type cells when YAP1 was concurrently depleted. These findings highlight the involvement of YAP1 in coupling mitochondrial dysfunction with mitochondrial shuttling of TERT to constitute an essential non-canonical function of YAP1 in the regulation of redox homeostasis. This article has an associated First Person interview with the first author of the paper.
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Affiliation(s)
- Shruti Patrick
- Division of Cellular and Molecular Neuroscience, National Brain Research Centre, Manesar 122052, India
| | - Pruthvi Gowda
- Division of Cellular and Molecular Neuroscience, National Brain Research Centre, Manesar 122052, India
| | - Kirti Lathoria
- Division of Cellular and Molecular Neuroscience, National Brain Research Centre, Manesar 122052, India
| | - Vaishali Suri
- Department of Pathology, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Ellora Sen
- Division of Cellular and Molecular Neuroscience, National Brain Research Centre, Manesar 122052, India
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Chen R, Wang X, Dai Z, Wang Z, Wu W, Hu Z, Zhang X, Liu Z, Zhang H, Cheng Q. TNFSF13 Is a Novel Onco-Inflammatory Marker and Correlates With Immune Infiltration in Gliomas. Front Immunol 2021; 12:713757. [PMID: 34712225 PMCID: PMC8546343 DOI: 10.3389/fimmu.2021.713757] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 09/13/2021] [Indexed: 12/21/2022] Open
Abstract
Existing therapeutic strategies for gliomas are restricted; hence, exploration for novel diagnostic indicator and treatment is essential. Here, we performed bioinformatic analyses for TNFSF13 (also known as APRIL), a proliferation-inducing ligand of the tumor necrosis factor (TNF) superfamily, aiming to assess its potential for predicting glioma patient’s prognosis and targeted therapy. TNFSF13 expression was upregulated in the increase of tumor grades based on Xiangya cohort. In high TNFSF13 gliomas, somatic mutation was proved to correlate with amplification of EGFR and deletion of CDKN2A; while mutation of IDH1 was more frequently observed in low TNFSF13 group. We also confirmed the positive correlation between TNFSF13 and infiltrating immune and stromal cells in glioma microenvironment. Further, TNFSF13 was found to be involved in immunosuppression via diverse immunoregulation pathways and was associated with other immune checkpoints and inflammation. Single-cell sequencing revealed an abundant expression of TNFSF13 in neoplastic cells and M2 macrophages, which TNFSF13 might potentially regulate the cell communication via IL-8, C3, and CD44. Lastly, TNFSF13 mediated the activities of transcription factors including FOXO3, MEIS2, and IRF8. Our analyses demonstrated the relevance between TNFSF13 and glioma progress and indicated the potential of TNFSF13 as a novel diagnostic onco-inflammatory biomarker and immunotherapy target of gliomas.
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Affiliation(s)
- Rui Chen
- Department of Neurosurgery, The Affiliated Nanhua Hospital, Hengyang Medical School, University of South China, Hengyang, China
| | - Xinxing Wang
- Department of Orthopedics, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Ziyu Dai
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China
| | - Zeyu Wang
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China
| | - Wantao Wu
- Department of Oncology, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Zhengang Hu
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China
| | - Xun Zhang
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China
| | - Zhixiong Liu
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China
| | - Hao Zhang
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China
| | - Quan Cheng
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.,Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, China
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14
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Noor H, Briggs NE, McDonald KL, Holst J, Vittorio O. TP53 Mutation Is a Prognostic Factor in Lower Grade Glioma and May Influence Chemotherapy Efficacy. Cancers (Basel) 2021; 13:5362. [PMID: 34771529 PMCID: PMC8582451 DOI: 10.3390/cancers13215362] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 10/17/2021] [Accepted: 10/22/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Identification of prognostic biomarkers in cancers is a crucial step to improve overall survival (OS). Although mutations in tumour protein 53 (TP53) is prevalent in astrocytoma, the prognostic effects of TP53 mutation are unclear. METHODS In this retrospective study, we sequenced TP53 exons 1 to 10 in a cohort of 102 lower-grade glioma (LGG) subtypes and determined the prognostic effects of TP53 mutation in astrocytoma and oligodendroglioma. Publicly available datasets were analysed to confirm the findings. RESULTS In astrocytoma, mutations in TP53 codon 273 were associated with a significantly increased OS compared to the TP53 wild-type (HR (95% CI): 0.169 (0.036-0.766), p = 0.021). Public datasets confirmed these findings. TP53 codon 273 mutant astrocytomas were significantly more chemosensitive than TP53 wild-type astrocytomas (HR (95% CI): 0.344 (0.13-0.88), p = 0.0148). Post-chemotherapy, a significant correlation between TP53 and YAP1 mRNA was found (p = 0.01). In O (6)-methylguanine methyltransferase (MGMT) unmethylated chemotherapy-treated astrocytoma, both TP53 codon 273 and YAP1 mRNA were significant prognostic markers. In oligodendroglioma, TP53 mutations were associated with significantly decreased OS. CONCLUSIONS Based on these findings, we propose that certain TP53 mutant astrocytomas are chemosensitive through the involvement of YAP1, and we outline a potential mechanism. Thus, TP53 mutations may be key drivers of astrocytoma therapeutic efficacy and influence survival outcomes.
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Affiliation(s)
- Humaira Noor
- Cure Brain Cancer Biomarkers and Translational Research Group, Prince of Wales Clinical School, University of New South Wales, Sydney, NSW 2031, Australia;
- Adult Cancer Program, Lowy Cancer Research Centre, UNSW Sydney, Randwick, NSW 2031, Australia;
| | - Nancy E. Briggs
- Stats Central, Mark Wainwright Analytical Centre, University of New South Wales, Sydney, NSW 2031, Australia;
| | - Kerrie L. McDonald
- Cure Brain Cancer Biomarkers and Translational Research Group, Prince of Wales Clinical School, University of New South Wales, Sydney, NSW 2031, Australia;
- Adult Cancer Program, Lowy Cancer Research Centre, UNSW Sydney, Randwick, NSW 2031, Australia;
| | - Jeff Holst
- Adult Cancer Program, Lowy Cancer Research Centre, UNSW Sydney, Randwick, NSW 2031, Australia;
- Translational Cancer Metabolism Laboratory, School of Medical Sciences, Prince of Wales Clinical School, UNSW Sydney, Sydney, NSW 2031, Australia
| | - Orazio Vittorio
- School of Women’s & Children’s Health, UNSW Medicine, University of NSW, Randwick, NSW 2031, Australia;
- Children’s Cancer Institute, Lowy Cancer Research Centre, UNSW Sydney, Randwick, NSW 2031, Australia
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15
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IDH Inhibitors and Beyond: The Cornerstone of Targeted Glioma Treatment. Mol Diagn Ther 2021; 25:457-473. [PMID: 34095989 DOI: 10.1007/s40291-021-00537-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2021] [Indexed: 12/12/2022]
Abstract
Diffuse low-grade gliomas account for approximately 20% of all primary brain tumors, they arise from glial cells and show infiltrative growth without histological features of malignancy. Mutations of the IDH1 and IDH2 genes constitute a reliable molecular signature of low-grade gliomas and are the earliest driver mutations occurring during gliomagenesis, representing a relevant biomarker with diagnostic, prognostic, and predictive value. IDH mutations induce a neomorphic enzyme that converts α-ketoglutarate to the oncometabolite D-2-hydroxyglutarate, which leads to widespread effects on cellular epigenetics and metabolism. Currently, there are no approved molecularly targeted therapies and the standard treatment for low-grade gliomas consists of radiation therapy and chemotherapy, with rising concern about treatment-related toxicities. Targeting D-2-hydroxyglutarate is considered a novel attractive therapeutic approach for low-grade gliomas and the insights from clinical trials suggest that mutant-selective IDH inhibitors are the ideal candidates, with a favorable benefit/risk ratio. A pivotal question is whether blocking IDH neomorphic activity may activate alternative oncogenetic pathways, inducing acquired resistance to IDH inhibitors. Based on this rationale, combination therapies to enhance the antitumor activity of IDH inhibitors and approaches aimed at exploiting, rather than inhibiting, the metabolism of IDH-mutant cancer cells, such as poly (adenosine 5'-diphosphate-ribose) polymerase inhibitors, are emerging from preclinical research and clinical trials. In this review, we discuss the pivotal role of IDH mutations in gliomagenesis and the complex interactions between the genomic and epigenetic landscapes, providing an overview of how, in the last decade, therapeutic approaches for low-grade gliomas have evolved.
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16
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Hu L, Cheng X, Binder Z, Han Z, Yin Y, O'Rourke DM, Wang S, Feng Y, Weng C, Wu A, Lin Z. Molecular and Clinical Characterization of UBE2S in Glioma as a Biomarker for Poor Prognosis and Resistance to Chemo-Radiotherapy. Front Oncol 2021; 11:640910. [PMID: 34123793 PMCID: PMC8190380 DOI: 10.3389/fonc.2021.640910] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 05/07/2021] [Indexed: 01/06/2023] Open
Abstract
Glioblastoma is the most common and lethal brain cancer globally. Clinically, this cancer has heterogenous molecular and clinical characteristics. Studies have shown that UBE2S is highly expressed in many cancers. But its expression profile in glioma, and the correlation with clinical outcomes is unknown. RNA sequencing data of glioma samples was downloaded from the Chinese Glioma Genome Atlas and The Cancer Genome Atlas. A total of 114 cases of glioma tissue samples (WHO grades II-IV) were used to conduct protein expression assays. The molecular and biological characteristics of UBE2S, and its prognostic value were analyzed. The results showed that high UBE2S expression was associated with a higher grade of glioma and PTEN mutations. In addition, UBE2S affected the degree of malignancy of glioma and the development of chemo-radiotherapy resistance. It was also found to be an independent predictor of worse survival of LGG patients. Furthermore, we identified five UBE2S ubiquitination sites and found that UBE2S was associated with Akt phosphorylation in malignant glioblastoma. The results also revealed that UBE2S expression was negatively correlated with 1p19q loss and IDH1 mutation; positively correlated with epidermal growth factor receptor amplification and PTEN mutation. This study demonstrates that UBE2S expression strongly correlates with glioma malignancy and resistance to chemo-radiotherapy. It is also a crucial biomarker of poor prognosis.
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Affiliation(s)
- Li Hu
- Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Xingbo Cheng
- Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Zev Binder
- Department of Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States
| | - Zhibin Han
- Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Yibo Yin
- Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Donald M O'Rourke
- Department of Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States
| | - Sida Wang
- Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Yumeng Feng
- Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Changjiang Weng
- State Key Laboratory of Veterinary Biotechnology, Harbin Veterinary Research Institute of Chinese Academy of Agricultural Sciences, Harbin, China
| | - Anhua Wu
- Department of Neurosurgery, The First Hospital of China Medical University, Shenyang, China
| | - Zhiguo Lin
- Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China
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17
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Ferreyra Vega S, Olsson Bontell T, Corell A, Smits A, Jakola AS, Carén H. DNA methylation profiling for molecular classification of adult diffuse lower-grade gliomas. Clin Epigenetics 2021; 13:102. [PMID: 33941250 PMCID: PMC8091784 DOI: 10.1186/s13148-021-01085-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 04/20/2021] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND DNA methylation profiling has facilitated and improved the classification of a wide variety of tumors of the central nervous system. In this study, we investigated the potential utility of DNA methylation profiling to achieve molecular diagnosis in adult primary diffuse lower-grade glioma (dLGG) according to WHO 2016 classification system. We also evaluated whether methylation profiling could provide improved molecular characterization and identify prognostic differences beyond the classical histological WHO grade together with IDH mutation status and 1p/19q codeletion status. All patients diagnosed with dLGG in the period 2007-2016 from the Västra Götaland region in Sweden were assessed for inclusion in the study. RESULTS A total of 166 dLGG cases were subjected for genome-wide DNA methylation analysis. Of these, 126 (76%) were assigned a defined diagnostic methylation class with a class prediction score ≥ 0.84 and subclass score ≥ 0.50. The assigned methylation classes were highly associated with their IDH mutation status and 1p/19q codeletion status. IDH-wildtype gliomas were further divided into subgroups with distinct molecular features. CONCLUSION The stratification of the patients by methylation profiling was as effective as the integrated WHO 2016 molecular reclassification at predicting the clinical outcome of the patients. Our study shows that DNA methylation profiling is a reliable and robust approach for the classification of dLGG into molecular defined subgroups, providing accurate detection of molecular markers according to WHO 2016 classification.
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Affiliation(s)
- Sandra Ferreyra Vega
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Sahlgrenska Center for Cancer Research, Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Thomas Olsson Bontell
- Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Clinical Pathology and Cytology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Alba Corell
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Anja Smits
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Neuroscience, Neurology, Uppsala University, Uppsala, Sweden
| | - Asgeir Store Jakola
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Neurosurgery, St. Olavs University Hospital, Trondheim, Norway
| | - Helena Carén
- Sahlgrenska Center for Cancer Research, Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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18
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Garton ALA, Kinslow CJ, Rae AI, Mehta A, Pannullo SC, Magge RS, Ramakrishna R, McKhann GM, Sisti MB, Bruce JN, Canoll P, Cheng SK, Sonabend AM, Wang TJC. Extent of resection, molecular signature, and survival in 1p19q-codeleted gliomas. J Neurosurg 2021; 134:1357-1367. [PMID: 32384274 DOI: 10.3171/2020.2.jns192767] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 02/28/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Genomic analysis in neurooncology has underscored the importance of understanding the patterns of survival in different molecular subtypes within gliomas and their responses to treatment. In particular, diffuse gliomas are now principally characterized by their mutation status (IDH1 and 1p/19q codeletion), yet there remains a paucity of information regarding the prognostic value of molecular markers and extent of resection (EOR) on survival. Furthermore, given the modern emphasis on molecular rather than histological diagnosis, it is important to examine the effect of maximal resection on survival in all gliomas with 1p/q19 codeletions, as these will now be classified as oligodendrogliomas under the new WHO guidelines. The objectives of the present study were twofold: 1) to assess the association between EOR and survival for patients with oligodendrogliomas in the National Cancer Database (NCDB), which includes information on mutation status, and 2) to demonstrate the same effect for all patients with 1p/19q codeleted gliomas in the NCDB. METHODS The NCDB was queried for all cases of oligodendroglioma between 2004 and 2014, with follow-up dates through 2016. The authors found 2514 cases of histologically confirmed oligodendrogliomas for the final analysis of the effect of EOR on survival. Upon further query, 1067 1p/19q-codeleted tumors were identified in the NCDB. Patients who received subtotal resection (STR) or gross-total resection (GTR) were compared to those who received no tumor debulking surgery. Univariable and multivariable analyses of both overall survival and cause-specific survival were performed. RESULTS EOR was associated with increased overall survival for both histologically confirmed oligodendrogliomas and all 1p/19q-codeleted-defined tumors (p < 0.001 and p = 0.002, respectively). Tumor grade, location, and size covaried predictably with EOR. When evaluating tumors by each classification system for predictors of overall survival, facility setting, age, comorbidity index, grade, location, chemotherapy, and radiation therapy were all shown to be significantly associated with overall survival. STR and GTR were independent predictors of improved survival in historically classified oligodendrogliomas (HR 0.83, p = 0.18; HR 0.69, p = 0.01, respectively) and in 1p/19q-codeleted tumors (HR 0.49, p < 0.01; HR 0.43, p < 0.01, respectively). CONCLUSIONS By using the NCDB, the authors have demonstrated a side-by-side comparison of the survival benefits of greater EOR in 1p/19q-codeleted gliomas.
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Affiliation(s)
- Andrew L A Garton
- 1Department of Neurological Surgery, NewYork-Presbyterian Hospital/Weill Cornell Medical Center
| | - Connor J Kinslow
- 2Department of Radiation Oncology, Vagelos College of Physicians and Surgeons, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York
| | - Ali I Rae
- 3Department of Neurological Surgery, Oregon Health & Sciences University, Portland, Oregon
| | - Amol Mehta
- 4Department of Neurology, Vagelos College of Physicians and Surgeons, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center
| | - Susan C Pannullo
- 1Department of Neurological Surgery, NewYork-Presbyterian Hospital/Weill Cornell Medical Center
| | - Rajiv S Magge
- 5Department of Radiation Oncology, NewYork-Presbyterian Hospital/Weill Cornell Medical Center
| | - Rohan Ramakrishna
- 1Department of Neurological Surgery, NewYork-Presbyterian Hospital/Weill Cornell Medical Center
| | - Guy M McKhann
- 6Department of Neurological Surgery, Vagelos College of Physicians and Surgeons, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center
| | - Michael B Sisti
- 6Department of Neurological Surgery, Vagelos College of Physicians and Surgeons, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center
| | - Jeffrey N Bruce
- 6Department of Neurological Surgery, Vagelos College of Physicians and Surgeons, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center
| | - Peter Canoll
- 7Herbert Irving Comprehensive Cancer Center, Vagelos College of Physicians and Surgeons, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center
- 8Departments of Pathology and Cell Biology, Vagelos College of Physicians and Surgeons, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center
| | - Simon K Cheng
- 2Department of Radiation Oncology, Vagelos College of Physicians and Surgeons, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York
- 9Department of Epidemiology, Mailman School of Public Health, and Department of Medicine, Vagelos College of Physicians and Surgeons, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York; and
| | - Adam M Sonabend
- 10Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Tony J C Wang
- 2Department of Radiation Oncology, Vagelos College of Physicians and Surgeons, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York
- 7Herbert Irving Comprehensive Cancer Center, Vagelos College of Physicians and Surgeons, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center
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19
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Lasica AB, Jaunmuktane Z, Fersht N, Kirkman MA, Dixon L, Hoskote C, Brandner S, Samandouras G. Genomic Prognosticators and Extent of Resection in Molecularly Subtyped World Health Organization Grade II and III Gliomas-A Single-Institution, Nine-Year Data. World Neurosurg 2021; 151:e217-e233. [PMID: 33866029 DOI: 10.1016/j.wneu.2021.04.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 04/05/2021] [Accepted: 04/06/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND World Health Organization (WHO) grade II and III isocitrate dehydrogenase wild-type (IDH-wt) gliomas are often treated as WHO grade IV glioblastomas. However, cumulative evidence indicates that IDH mutation status alone is insufficient in predicting survival. The current study examines molecular and clinical markers to further prognostically stratify WHO grade II and III gliomas, in particular, IDH-wt. METHODS A single institution's records were retrospectively reviewed for molecularly stratified WHO grade II and grade III gliomas over a 9-year period (2010-2019). Clinical data, IDH1/IDH2 status, EGFR amplification, and other molecular markers were recorded and correlated to the study outcomes. These outcomes were defined as progression-free survival (PFS), overall survival (OS), and time to malignant progression (TtMP). RESULTS A total of 167 and 42 WHO grade II and III gliomas, respectively, were identified, totaling 209 cases with 157 IDH1/2 mutated and 52 IDH-wt tumors. The presence of IDH1/2 mutation was associated with longer OS (P < 0.0001) and PFS (P < 0.0001) but not with TtMP (P = 0.314). Lack of EGFR amplification, younger age, and greater extent of resection (EOR) (≥80%) were identified as independent, favorable OS prognostic factors. In the IDH-wt cohort, multivariate analysis indicated that older age (P = 0.003) and lesser EOR (<80%) (P = 0.007) are associated with worse OS. In addition, EGFR amplification showed a trend toward shorter OS in the IDH-wt cohort (P = 0.073). CONCLUSIONS IDH1/2 mutation favors longer OS and PFS but does not protect from malignant progression. Lack of EGFR amplification, younger age and greater EOR are favorable OS prognosticators. In the IDH-wt cohort, older age and lesser EOR were linked to worse OS.
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Affiliation(s)
- Aleksandra B Lasica
- Victor Horsley Department of Neurosurgery, The National Hospital for Neurology and Neurosurgery, Queen Square, University College London Hospitals NHS Foundation Trust, London, United Kingdom.
| | - Zane Jaunmuktane
- Division of Neuropathology, The National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, United Kingdom; Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Naomi Fersht
- Department of Oncology, University College London Hospitals, London, United Kingdom
| | - Matthew A Kirkman
- Victor Horsley Department of Neurosurgery, The National Hospital for Neurology and Neurosurgery, Queen Square, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Luke Dixon
- Lysholm Department of Neuroradiology, The National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Chandrashekar Hoskote
- Lysholm Department of Neuroradiology, The National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Sebastian Brandner
- Division of Neuropathology, The National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, United Kingdom; Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - George Samandouras
- Victor Horsley Department of Neurosurgery, The National Hospital for Neurology and Neurosurgery, Queen Square, University College London Hospitals NHS Foundation Trust, London, United Kingdom; Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, United Kingdom
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20
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Zhang H, Zhou Y, Cheng Q, Dai Z, Wang Z, Liu F, Fan F, Cui B, Cao H. PDIA3 correlates with clinical malignant features and immune signature in human gliomas. Aging (Albany NY) 2021; 12:15392-15413. [PMID: 32687065 PMCID: PMC7467394 DOI: 10.18632/aging.103601] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 06/13/2020] [Indexed: 01/03/2023]
Abstract
Since therapeutic strategies are limited in gliomas, new molecules or biomarkers are essential for diagnosis and therapy. Here, we investigated expression of protein disulfide isomerase family A member 3 (PDIA3) in gliomas to evaluate its potential as a promising immune target or biomarker. Transcriptome level, genomic profiles and its association with clinical practice from TCGA and CGGA databases were analyzed. All statistical analyses were performed using R project. In gliomas with high PDIA3 expression, somatic mutations showed the correlation with loss of PTEN and amplification of EGFR; meanwhile, in PDIA3 low gliomas, mutations in isocitrate dehydrogenase (IDH) took 80%. Moreover, PDIA3 was found to positively correlate with ESTIMATE scores and diverse infiltrating immune and stromal cell types localizing in tumor microenvironment. PDIA3 was found to be highly correlated with macrophage and T cells based on single cell sequencing. Additionally, PDIA3 was also involved in suppression of anti-tumor immunity via multiple immune regulatory processes. Finally, PDIA3 was observed to correlate with other immune checkpoint inhibitors and associated with inflammation. Our findings identified the significance of PDIA3 in the process of gliomas and demonstrated the potential of PDIA3 as a molecular target in prognosis and immune related treatment of gliomas
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Affiliation(s)
- Hao Zhang
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China.,Equal contribution
| | - Yulai Zhou
- Department of Oncology, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China.,Equal contribution
| | - Quan Cheng
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China.,Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Hunan, China
| | - Ziyu Dai
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China
| | - Zeyu Wang
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China
| | - Fangkun Liu
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China
| | - Fan Fan
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China
| | - Biqi Cui
- Department of Neurology, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China
| | - Hui Cao
- Department of Psychiatry, The Second People’s Hospital of Hunan Province, The Hospital of Hunan University of Chinese Medicine, Changsha, Hunan, China
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21
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Zhang H, Cui B, Zhou Y, Wang X, Wu W, Wang Z, Dai Z, Cheng Q, Yang K. B2M overexpression correlates with malignancy and immune signatures in human gliomas. Sci Rep 2021; 11:5045. [PMID: 33658560 PMCID: PMC7930032 DOI: 10.1038/s41598-021-84465-6] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 02/17/2021] [Indexed: 12/11/2022] Open
Abstract
Because of the limited treatment strategy of gliomas, the key of diagnosis and treatment is finding new molecular biomarkers. Here, we explored the potential of β2-microglobulin (B2M) to serve as a hopeful candidate for immunotherapy or diagnostic biomarker in gliomas. The genomic profiles, clinical characteristics, and immune signatures were analyzed based on TCGA and CGGA databases. We carried out the whole statistical analyses using R project. High B2M expression correlated with worse prognosis. Somatic mutations of gliomas with high B2M expression are associated with PTEN deletion and EGFR amplification. Isocitrate dehydrogenase (IDH) mutations accounted for 82% in gliomas with low B2M expression. In addition, B2M positively correlated with ESTIMATE scores, interacted with infiltrating immune and stromal cell types. B2M also suppressed anti-tumor immunity through immune related processes. Meanwhile, B2M was associated with immune checkpoint molecules and inflammatory activities. Finally, functional annotation of the identified B2M related genes verified that B2M was a potential candidate for immunotherapy. We confirmed that B2M played a critical role in tumor progression, patient prognosis and immunotherapy of gliomas.
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Affiliation(s)
- Hao Zhang
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, People's Republic of China
| | - Biqi Cui
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, People's Republic of China
| | - Yulai Zhou
- Department of Oncology, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, People's Republic of China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, People's Republic of China
| | - Xinxing Wang
- Department of Orthopedics, The Third Xiangya Hospital, Central South University, Changsha, 410008, Hunan, People's Republic of China
| | - Wantao Wu
- Department of Oncology, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, People's Republic of China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, People's Republic of China
| | - Zeyu Wang
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, People's Republic of China
| | - Ziyu Dai
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, People's Republic of China
| | - Quan Cheng
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, People's Republic of China. .,Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, People's Republic of China.
| | - Kui Yang
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, People's Republic of China.
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22
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Divé I, Steidl E, Wagner M, Filipski K, Burger MC, Franz K, Harter PN, Bähr O, Fokas E, Herrlinger U, Steinbach JP. Gliomatosis Cerebri Growth Pattern: Association of Differential First-Line Treatment with Overall Survival in WHO Grade II and III Gliomas. Oncology 2021; 99:215-224. [PMID: 33472203 DOI: 10.1159/000512562] [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: 09/14/2020] [Accepted: 10/26/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Gliomatosis cerebri (GC) is defined by diffuse, widespread glial tumor growth affecting three or more cerebral lobes. Previous studies in gliomas found no distinct histological or molecular GC subtype, yet the presence of GC is associated with worse median overall survival (OS). Here, we explored whether differing therapeutic strategies in first-line treatment could account for this. METHODS From our University Cancer Center database, 47 patients with histological diagnosis of WHO grade II or III glioma and GC imaging pattern were identified. GC criteria were confirmed by independent review. Patients with WHO grade II or III glioma with non-GC pattern served as control cohort (n = 343). RESULTS Within the GC patient cohort, lower WHO grade, mutated isocitrate dehydrogenase 1 (IDH1) status, and absence of contrast enhancement were associated with better OS. Compared to the control cohort, patients with GC had significantly shorter OS independent of histological diagnosis or IDH1 mutation status. Patients with GC preferentially received chemotherapy alone (62 vs. 18%), and less frequently radiochemotherapy (21 vs. 27%). OS was significantly shorter in the GC cohort compared to the non-GC cohort both for chemotherapy (3.9 vs. 7.6 years, p = 0.0085) and for combined radiochemotherapy (1.1 vs. 8.4 years, p < 0.0001). However, when only patients who received biopsy plus chemotherapy were analyzed, the differences lost statistical significance (3.5 vs. 6.6 years, p = 0.196). CONCLUSION We found major differences in the selection of first-line therapies of GC versus non-GC patients. Our results suggest that these differences may partly account for the worse prognosis of GC patients.
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Affiliation(s)
- Iris Divé
- Dr. Senckenberg Institute of Neurooncology, Goethe University, Frankfurt am Main, Germany, .,University Cancer Center Frankfurt (UCT), Goethe University, Frankfurt am Main, Germany, .,Frankfurt Cancer Institute (FCI), Goethe University, Frankfurt am Main, Germany, .,German Cancer Consortium (DKTK), Partner Site Frankfurt/Mainz, Frankfurt am Main, Germany,
| | - Eike Steidl
- University Cancer Center Frankfurt (UCT), Goethe University, Frankfurt am Main, Germany.,German Cancer Consortium (DKTK), Partner Site Frankfurt/Mainz, Frankfurt am Main, Germany.,Institute of Neuroradiology, Goethe University, Frankfurt am Main, Germany
| | - Marlies Wagner
- University Cancer Center Frankfurt (UCT), Goethe University, Frankfurt am Main, Germany.,Frankfurt Cancer Institute (FCI), Goethe University, Frankfurt am Main, Germany.,German Cancer Consortium (DKTK), Partner Site Frankfurt/Mainz, Frankfurt am Main, Germany.,Institute of Neuroradiology, Goethe University, Frankfurt am Main, Germany
| | - Katharina Filipski
- University Cancer Center Frankfurt (UCT), Goethe University, Frankfurt am Main, Germany.,Frankfurt Cancer Institute (FCI), Goethe University, Frankfurt am Main, Germany.,German Cancer Consortium (DKTK), Partner Site Frankfurt/Mainz, Frankfurt am Main, Germany.,Institute of Neurology (Edinger-Institute), Goethe University, Frankfurt am Main, Germany
| | - Michael C Burger
- Dr. Senckenberg Institute of Neurooncology, Goethe University, Frankfurt am Main, Germany.,University Cancer Center Frankfurt (UCT), Goethe University, Frankfurt am Main, Germany.,Frankfurt Cancer Institute (FCI), Goethe University, Frankfurt am Main, Germany.,German Cancer Consortium (DKTK), Partner Site Frankfurt/Mainz, Frankfurt am Main, Germany
| | - Kea Franz
- Dr. Senckenberg Institute of Neurooncology, Goethe University, Frankfurt am Main, Germany.,University Cancer Center Frankfurt (UCT), Goethe University, Frankfurt am Main, Germany.,Frankfurt Cancer Institute (FCI), Goethe University, Frankfurt am Main, Germany.,German Cancer Consortium (DKTK), Partner Site Frankfurt/Mainz, Frankfurt am Main, Germany.,Department of Neurosurgery, Goethe University, Frankfurt am Main, Germany
| | - Patrick N Harter
- University Cancer Center Frankfurt (UCT), Goethe University, Frankfurt am Main, Germany.,Frankfurt Cancer Institute (FCI), Goethe University, Frankfurt am Main, Germany.,German Cancer Consortium (DKTK), Partner Site Frankfurt/Mainz, Frankfurt am Main, Germany.,Institute of Neurology (Edinger-Institute), Goethe University, Frankfurt am Main, Germany
| | - Oliver Bähr
- Dr. Senckenberg Institute of Neurooncology, Goethe University, Frankfurt am Main, Germany.,University Cancer Center Frankfurt (UCT), Goethe University, Frankfurt am Main, Germany.,Frankfurt Cancer Institute (FCI), Goethe University, Frankfurt am Main, Germany.,German Cancer Consortium (DKTK), Partner Site Frankfurt/Mainz, Frankfurt am Main, Germany
| | - Emmanouil Fokas
- University Cancer Center Frankfurt (UCT), Goethe University, Frankfurt am Main, Germany.,Frankfurt Cancer Institute (FCI), Goethe University, Frankfurt am Main, Germany.,German Cancer Consortium (DKTK), Partner Site Frankfurt/Mainz, Frankfurt am Main, Germany.,Department of Radiotherapy and Oncology, Goethe University, Frankfurt am Main, Germany
| | - Ulrich Herrlinger
- Department of Neurology, University Medical Center Bonn, Bonn, Germany
| | - Joachim P Steinbach
- Dr. Senckenberg Institute of Neurooncology, Goethe University, Frankfurt am Main, Germany.,University Cancer Center Frankfurt (UCT), Goethe University, Frankfurt am Main, Germany.,Frankfurt Cancer Institute (FCI), Goethe University, Frankfurt am Main, Germany.,German Cancer Consortium (DKTK), Partner Site Frankfurt/Mainz, Frankfurt am Main, Germany
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23
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Liu Y, Lang F, Chou FJ, Zaghloul KA, Yang C. Isocitrate Dehydrogenase Mutations in Glioma: Genetics, Biochemistry, and Clinical Indications. Biomedicines 2020; 8:biomedicines8090294. [PMID: 32825279 PMCID: PMC7554955 DOI: 10.3390/biomedicines8090294] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 08/13/2020] [Accepted: 08/17/2020] [Indexed: 12/22/2022] Open
Abstract
Mutations in isocitrate dehydrogenase (IDH) are commonly observed in lower-grade glioma and secondary glioblastomas. IDH mutants confer a neomorphic enzyme activity that converts α-ketoglutarate to an oncometabolite D-2-hydroxyglutarate, which impacts cellular epigenetics and metabolism. IDH mutation establishes distinctive patterns in metabolism, cancer biology, and the therapeutic sensitivity of glioma. Thus, a deeper understanding of the roles of IDH mutations is of great value to improve the therapeutic efficacy of glioma and other malignancies that share similar genetic characteristics. In this review, we focused on the genetics, biochemistry, and clinical impacts of IDH mutations in glioma.
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Affiliation(s)
- Yang Liu
- Neuro-Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD 20892, USA; (Y.L.); (F.L.); (F.-J.C.)
| | - Fengchao Lang
- Neuro-Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD 20892, USA; (Y.L.); (F.L.); (F.-J.C.)
| | - Fu-Ju Chou
- Neuro-Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD 20892, USA; (Y.L.); (F.L.); (F.-J.C.)
| | - Kareem A. Zaghloul
- Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892, USA;
| | - Chunzhang Yang
- Neuro-Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD 20892, USA; (Y.L.); (F.L.); (F.-J.C.)
- Correspondence: ; Tel.: +1-240-760-7083
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24
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Young JS, Gogos AJ, Morshed RA, Hervey-Jumper SL, Berger MS. Molecular characteristics of diffuse lower grade gliomas: what neurosurgeons need to know. Acta Neurochir (Wien) 2020; 162:1929-1939. [PMID: 32472378 DOI: 10.1007/s00701-020-04426-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 05/21/2020] [Indexed: 01/03/2023]
Abstract
The importance of genomic information in intrinsic brain tumors is highlighted in the World Health Organization (WHO) 2016 classification of gliomas, which now incorporates both phenotype and genotype data to assign a diagnosis. By using genetic markers to both categorize tumors and advise patients on prognosis, this classification system has minimized the risk of tissue sampling error, improved diagnostic accuracy, and reduced inter-rater variability. In the neurosurgical community, it is critical to understand the role genetics plays in tumor biology, what certain mutations mean for the patient's prognosis and adjuvant treatment, and how to interpret the results of sequencing data that are generated following tumor resection. In this review, we examine the critical role of genetics for diagnosis and prognosis and highlight the importance of tumor genetics for neurosurgeons caring for patients with diffuse lower grade gliomas.
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Affiliation(s)
- Jacob S Young
- Department of Neurosurgery, University of California San Francisco, San Francisco, CA, USA.
| | - Andrew J Gogos
- Department of Neurosurgery, University of California San Francisco, San Francisco, CA, USA
| | - Ramin A Morshed
- Department of Neurosurgery, University of California San Francisco, San Francisco, CA, USA
| | - Shawn L Hervey-Jumper
- Department of Neurosurgery, University of California San Francisco, San Francisco, CA, USA
| | - Mitchel S Berger
- Department of Neurosurgery, University of California San Francisco, San Francisco, CA, USA
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25
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Malueka RG, Dwianingsih EK, Bayuangga HF, Panggabean AS, Argo IW, Donurizki AD, Shaleh S, Wicaksono AS, Dananjoyo K, Asmedi A, Hartanto RA. Clinicopathological Features and Prognosis of Indonesian Patients with Gliomas with IDH Mutation: Insights into Its Significance in a Southeast Asian Population. Asian Pac J Cancer Prev 2020; 21:2287-2295. [PMID: 32856857 PMCID: PMC7771930 DOI: 10.31557/apjcp.2020.21.8.2287] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Indexed: 12/28/2022] Open
Abstract
Background: Gliomas remain one of the most common primary brain tumors. Mutations in the isocitrate dehydrogenase (IDH) gene are associated with a distinct set of clinicopathological profiles. However, the distribution and significance of these mutations have never been studied in the Indonesian population. This study aimed to elucidate the association between IDH mutations and clinicopathological as well as prognostic profiles of Indonesian patients with gliomas. Methods: In total, 106 patients with gliomas were recruited from a tertiary academic medical center in Yogyakarta, Indonesia. Formalin-fixed paraffin-embedded and fresh tissue specimens were obtained and sectioned for hematoxylin-eosin staining and immunohistochemical examinations. Genomic DNA was isolated and analyzed for the presence of IDH mutations using standard polymerase chain reaction and nucleotide sequencing methods. Clinicopathological data were collected from medical records. Results: Although no IDH2 mutation was identified, IDH1 mutations were found in 23 (21.7%) of the patients. Patients with IDH1 mutations tended to have a history of smoking and a shorter interval between onset of symptoms and initial surgical interventions. Frontal lobe involvement, oligodendroglial histology, lower Ki67 expression, WHO grades II and III gliomas, and methylated O6-methylguanine-DNA methyltransferase (MGMT) promoters were significantly associated with the presence of IDH1 mutations. Compared with patients with IDH1-wild-type, patients with IDH1 mutation were observed to have a longer overall survival. Conclusions: IDH1 mutations are associated with certain clinicopathological and prognostic profiles in Indonesian patients with gliomas. This finding demonstrates the importance of identifying IDH mutations as part of the management of patients with glioma in Indonesia.
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Affiliation(s)
- Rusdy Ghazali Malueka
- Department of Neurology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Ery Kus Dwianingsih
- Department of Anatomical Pathology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Halwan Fuad Bayuangga
- Department of Neurology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Andre Stefanus Panggabean
- Department of Neurology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Ibnu Widya Argo
- Department of Neurology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Aditya Dwi Donurizki
- Department of Neurology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Sabillal Shaleh
- Department of Neurology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Adiguno Suryo Wicaksono
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Kusumo Dananjoyo
- Department of Neurology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Ahmad Asmedi
- Department of Neurology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Rachmat Andi Hartanto
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
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26
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Molecular Classification of Diffuse Gliomas. Can J Neurol Sci 2020; 47:464-473. [DOI: 10.1017/cjn.2020.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
ABSTRACT:Technological advances in the field of molecular genetics have improved the ability to classify brain tumors into subgroups with distinct clinical features and important therapeutic implications. The World Health Organization’s newest update on classification of gliomas (2016) incorporated isocitrate dehydrogenase 1 and 2 mutations, ATRX loss, 1p/19q codeletion status, and TP53 mutations to allow for improved classification of glioblastomas, low-grade and anaplastic gliomas. This paper reviews current advances in the understanding of diffuse glioma classification and the impact of molecular markers and DNA methylation studies on survival of patients with these tumors. We also discuss whether the classification and grading of diffuse gliomas should be based on histological findings, molecular markers, or DNA methylation subgroups in future iterations of the classification system.
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27
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Yu Z, Lu L. Comprehensive analysis of potential prognostic biomarker in gliomas. LIBRARY HI TECH 2020. [DOI: 10.1108/lht-08-2019-0173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeGliomas are common intracranial tumors with the characteristic of diffuse and invasive growth. The prognosis is poor, and the recurrence rate and mortality are higher. With the development of big data technology, many methods such as natural language processing, computer vision and image processing have been deeply applied in the medical field. This can help clinicians to provide personalized and precise diagnosis and therapeutic schedule for patients with different type of gliomas to achieve the best therapeutic effect. The purpose of this paper is to summarize and extract useful information from published research results by conducting a secondary analysis of the literature.Design/methodology/approachThe PubMed and China National Knowledge Infrastructure (CNKI) literature database were used to retrieve published Chinese and English research papers about human gliomas. Comprehensive analysis was applied to conduct this research. The factors affecting survival and prognosis were screened and analyzed respectively in this paper, and different methods for multidimensional data of patients were discussed.FindingsThis paper identified biomarkers and therapeutic modalities associated with prognosis for different grade of gliomas. This paper investigated the relationship among these clinical prognostic factors and different histopathologic tying and grade of gliomas by comprehensive analysis. This paper summarizes the research progress of biomarker in medical imaging and genomics of gliomas to improve prognosis and the current status of treatment in China.Originality/valueCombined with multimodal data such as genomics data, medical image data and clinical information data, this paper comprehensively analyzed the prognostic factors of glioma and provided guidance and evidence for rational treatment planning and improvement of clinical treatment prognosis.
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28
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Meredith DM. Advances in Diagnostic Immunohistochemistry for Primary Tumors of the Central Nervous System. Adv Anat Pathol 2020; 27:206-219. [PMID: 30720470 DOI: 10.1097/pap.0000000000000225] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
As genomic characterization becomes increasingly necessary for accurate diagnosis of tumors of the central nervous system, identification of rapidly assessible biomarkers is equally important to avoid excessive cost and delay in initiation of therapy. This article reviews novel immunohistochemical markers that may be used to determine mutation status, activation of signaling pathways, druggable targets, and cell lineage in many diverse tumor types. In particular, recently added entities to the 2016 WHO classification of central nervous system tumors will be addressed, including IDH-mutant gliomas, diffuse midline glioma, epithelioid glioblastoma, angiocentric glioma, RELA-rearranged ependymoma, embryonal tumors (medulloblastoma, atypical teratoid/rhabdoid tumor, pineoblastoma, embryonal tumor with multilayered rosettes, and other genetically defined high-grade neuroepithelial tumors), and meningiomas associated with germline alterations.
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D'Agate S, Wilson T, Adalig B, Manyak M, Palacios-Moreno JM, Chavan C, Oelke M, Roehrborn C, Della Pasqua O. Model-based meta-analysis of individual International Prostate Symptom Score trajectories in patients with benign prostatic hyperplasia with moderate or severe symptoms. Br J Clin Pharmacol 2020; 86:1585-1599. [PMID: 32144791 PMCID: PMC7373698 DOI: 10.1111/bcp.14268] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Revised: 02/01/2020] [Accepted: 02/11/2020] [Indexed: 12/01/2022] Open
Abstract
Aims International Prostate Symptom Score (IPSS) is a marker of lower urinary tract symptoms (LUTS) deterioration or improvement in benign prostate hyperplasia (BPH). Whereas changes in IPSS relative to baseline have been used as endpoints in clinical trials, little attention has been given to the time course of symptoms. The current investigation aimed to develop a drug‐disease model to describe individual IPSS trajectories in moderate and severe BPH patients. Methods A model‐based meta‐analytical approach was used including data from 10 238 patients enrolled into Phase III and IV studies receiving placebo, tamsulosin, dutasteride or combination therapy over a period of up to 4 years. Model predictive performance was assessed using statistical and graphical criteria. Subsequently, simulations were performed to illustrate the implications of treatment with drugs showing symptomatic and disease‐modifying properties in patients with varying disease progression rates. Results Improvement and worsening of IPSS could be characterized by a model including a sigmoid function which disentangles drug effects from placebo and varying disease progression rates on IPSS. Mean estimate (95% confidence intervals) for the disease progression rate was 0.319 (0.271–0.411) month−1. Treatment effect on IPSS (DELTA) was found to be 0.0605, 0.0139 and 0.0310 month−1 for placebo, tamsulosin and combination therapy, respectively. In addition, it appears that individual trajectories can be clustered together into different phenotypes describing the underlying disease progression rate (i.e. slow, moderate and fast progressors). Conclusions The availability of a drug‐disease model enables the evaluation of interindividual differences in disease progression rate, deterioration of symptoms and treatment effects on LUTS/BPH.
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Affiliation(s)
- Salvatore D'Agate
- Clinical Pharmacology and Therapeutics Group, University College London, London, UK
| | | | - Burkay Adalig
- Classic & Established Products, GSK, Istanbul, Turkey
| | - Michael Manyak
- Classic & Established Products, GSK, Washington, DC, USA
| | | | | | - Matthias Oelke
- Department of Urology, St Antonius Hospital, Gronau, Germany
| | - Claus Roehrborn
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Oscar Della Pasqua
- Clinical Pharmacology and Therapeutics Group, University College London, London, UK.,Clinical Pharmacology Modelling and Simulation, GSK, Uxbridge, Middlesex, UK
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Lim-Fat MJ, Nayak L, Meredith DM. Genomic Biomarker Assessment in Gliomas: Impacts of Molecular Testing on Clinical Practice and Trial Design. Surg Pathol Clin 2020; 13:209-215. [PMID: 32389262 DOI: 10.1016/j.path.2020.02.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Recent discoveries elucidating the genetic underpinnings of glial neoplasms have revealed myriad recurrent alterations that have clinical value by improving accuracy of diagnosis and prognosis. Furthermore, this wealth of genomic information provides the basis for targeted therapies and the subsequent design of biomarker-based clinical trials. This review summarizes the current landscape of clinically relevant molecular alterations in gliomas and describes the role of routine molecular testing in context of treatment planning for standards of care and clinical trials.
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Affiliation(s)
- Mary-Jane Lim-Fat
- Center for Neuro-Oncology, Dana Farber Cancer Institute, 450 Brookline Ave, Boston, MA 02215, USA
| | - Lakshmi Nayak
- Center for Neuro-Oncology, Dana Farber Cancer Institute, 450 Brookline Ave, Boston, MA 02215, USA
| | - David M Meredith
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.
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Ryall S, Tabori U, Hawkins C. Pediatric low-grade glioma in the era of molecular diagnostics. Acta Neuropathol Commun 2020; 8:30. [PMID: 32164789 PMCID: PMC7066826 DOI: 10.1186/s40478-020-00902-z] [Citation(s) in RCA: 187] [Impact Index Per Article: 46.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 02/21/2020] [Indexed: 12/17/2022] Open
Abstract
Low grade gliomas are the most frequent brain tumors in children and encompass a spectrum of histologic entities which are currently assigned World Health Organisation grades I and II. They differ substantially from their adult counterparts in both their underlying genetic alterations and in the infrequency with which they transform to higher grade tumors. Nonetheless, children with low grade glioma are a therapeutic challenge due to the heterogeneity in their clinical behavior – in particular, those with incomplete surgical resection often suffer repeat progressions with resultant morbidity and, in some cases, mortality. The identification of up-regulation of the RAS–mitogen-activated protein kinase (RAS/MAPK) pathway as a near universal feature of these tumors has led to the development of targeted therapeutics aimed at improving responses while mitigating patient morbidity. Here, we review how molecular information can help to further define the entities which fall under the umbrella of pediatric-type low-grade glioma. In doing so we discuss the specific molecular drivers of pediatric low grade glioma and how to effectively test for them, review the newest therapeutic agents and their utility in treating this disease, and propose a risk-based stratification system that considers both clinical and molecular parameters to aid clinicians in making treatment decisions.
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Su J, Ma Q, Long W, Tang H, Wu C, Luo M, Wang X, Xiao K, Li Y, Xiao Q, Zhang C, Li H, Liu Q. LCTL Is a Prognostic Biomarker and Correlates With Stromal and Immune Infiltration in Gliomas. Front Oncol 2019; 9:1083. [PMID: 31681612 PMCID: PMC6803540 DOI: 10.3389/fonc.2019.01083] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 10/01/2019] [Indexed: 01/08/2023] Open
Abstract
Immune evasion in glioma strongly correlates with clinical outcomes; however, the molecular mechanisms driving the maintenance of immunosuppression remain largely unknown. Recently studies demonstrate that Klothos are aberrantly expressed in several cancers and are potential therapeutic targets in cancers. However, their roles are still unclear in glioma. Here, we show that LCTL is highly expressed in gliomas and that its expression is regulated by DNA methylation status at the promoter. LCTL expression is also found to be significantly associated with high tumor aggressiveness and poor outcomes for glioma patients. Mechanistically, results suggested that LCTL might play an important immunosuppressive role by recruiting immunosuppressive cells and regulating tumor-associated macrophages polarization, T cell exhaustion, and epithelial–mesenchymal transition through FGF signaling in glioma. Our results establish LCTL as a key biomarker for prognosis that could be considered a potential epigenetic and immunotherapeutic target for treatment.
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Affiliation(s)
- Jun Su
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China
| | - Qianquan Ma
- Department of Neurosurgery, Peking University Third Hospital, Peking University, Beijing, China
| | - Wenyong Long
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China
| | - Hailin Tang
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Changwu Wu
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China
| | - Mei Luo
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China
| | - Xiangyu Wang
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China
| | - Kai Xiao
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China
| | - Yang Li
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China
| | - Qun Xiao
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China
| | - Chi Zhang
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China
| | - Haoyu Li
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China
| | - Qing Liu
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China.,Institute of Skull Base Surgery & Neuro-oncology at Hunan, Changsha, China
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Hamisch CA, Minartz J, Blau T, Hafkemeyer V, Rueß D, Hellerbach A, Grau SJ, Ruge MI. Frame-based stereotactic biopsy of deep-seated and midline structures in 511 procedures: feasibility, risk profile, and diagnostic yield. Acta Neurochir (Wien) 2019; 161:2065-2071. [PMID: 31359191 DOI: 10.1007/s00701-019-04020-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Accepted: 07/18/2019] [Indexed: 11/24/2022]
Abstract
OBJECTIVES We evaluated the feasibility, safety, and diagnostic yield of frame-based stereotactic biopsies (SB) in lesions located in deep-seated and midline structures of the brain to analyze these parameters in comparison to other brain areas. PATIENTS AND METHODS In a retrospective, tertiary care single-center analysis, we identified all patients who received SB for lesions localized in deep-seated and midline structures (corpus callosum, basal ganglia, pineal region, sella, thalamus, and brainstem) between January 1996 and June 2015. Study participants were between 1 and 82 years. We evaluated the feasibility, procedural complications (mortality, transient and permanent morbidity), and diagnostic yield. We further performed a risk analysis of factors influencing the latter parameters. Chi-square test, Student t test, and Mann-Whitney rank-sum test were used for statistical analysis. RESULTS Four hundred eighty-nine patients receiving 511 SB procedures (median age 48.5 years, range 1-82; median Karnofsky Performance Score 80%, range 50-100%, 43.8% female/56.2% male) were identified. Lesions were localized in the corpus callosum (29.5%), basal ganglia (17.0%), pineal region (11.5%), sella (7.8%), thalamus (4.3%), brainstem (28.8%), and others (1.1%). Procedure-related mortality was 0%, and permanent morbidity was 0.4%. Transient morbidity was 9.6%. Histological diagnosis was possible in 99.2% (low-grade gliomas 16.2%, high-grade gliomas 40.3%, other tumors in 27.8%, no neoplastic lesions 14.5%, no definitive histological diagnosis 0.8%). Only the pons location correlated significantly with transient morbidity (p < 0.001). CONCLUSION In experienced centers, frame-based stereotactic biopsy is a safe diagnostic tool with a high diagnostic yield also for deep-seated and midline lesions.
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Affiliation(s)
- Christina A Hamisch
- Department of General Neurosurgery, Center for Neurosurgery, University Hospital of Cologne, 50937, Cologne, Germany.
| | - Jana Minartz
- Department of Stereotaxy and Functional Neurosurgery, Center for Neurosurgery, University Hospital of Cologne, 50937, Köln, Germany
| | - Tobias Blau
- Department of Neuropathology, University Hospital of Essen, 45122, Essen, Germany
| | - Vanessa Hafkemeyer
- Department of Stereotaxy and Functional Neurosurgery, Center for Neurosurgery, University Hospital of Cologne, 50937, Köln, Germany
| | - Daniel Rueß
- Department of Stereotaxy and Functional Neurosurgery, Center for Neurosurgery, University Hospital of Cologne, 50937, Köln, Germany
| | - Alexandra Hellerbach
- Department of Stereotaxy and Functional Neurosurgery, Center for Neurosurgery, University Hospital of Cologne, 50937, Köln, Germany
| | - Stefan J Grau
- Department of General Neurosurgery, Center for Neurosurgery, University Hospital of Cologne, 50937, Cologne, Germany
- Center of Integrated Oncology (CIO), Universities of Cologne and Bonn, 53113, Bonn, Germany
| | - Maximilian I Ruge
- Department of Stereotaxy and Functional Neurosurgery, Center for Neurosurgery, University Hospital of Cologne, 50937, Köln, Germany
- Center of Integrated Oncology (CIO), Universities of Cologne and Bonn, 53113, Bonn, Germany
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To be Wild or Mutant: Role of Isocitrate Dehydrogenase 1 (IDH1) and 2-Hydroxy Glutarate (2-HG) in Gliomagenesis and Treatment Outcome in Glioma. Cell Mol Neurobiol 2019; 40:53-63. [PMID: 31485826 DOI: 10.1007/s10571-019-00730-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 08/23/2019] [Indexed: 12/20/2022]
Abstract
Molecular and clinical research based on isocitrate dehydrogenase (IDH) mutations is much sought after in glioma research since a decade of its discovery in 2008. IDH enzyme normally catalyzes isocitrate to α-keto-glutarate (α-KG), but once the gene is mutated it produces an 'oncometabolite', 2-hydroxyglutarate (2-HG). 2-HG is proposed to inhibit α-KG-dependent dioxygenases and also blocks cellular differentiation. Here, we discuss the role of the IDH1 mutation in gliomagenesis. The review also focuses on the effect of 2-HG on glioma epigenetics, the cellular signaling involved in IDH1 mutant glioma cells and the therapeutic response seen in mutant IDH1(mIDH1) harboring glioma patients in comparison to the patients with wild-type IDH1. The review encompasses the debatable impacts of the mutation on immune microenvironment a propos of various mIDH1 inhibitors in practice or in trials. Recent studies revealing the relation of IDH mutation with the immune microenvironment and inflammatory status in untreated versus treated glioblastoma patients are highlighted with respect to prospective therapeutic targets. Also at the molecular level, the association of mIDH1/2-HG with the intracellular components such as mitochondria and other neighboring cells is discussed.
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Radiosensitization and a Less Aggressive Phenotype of Human Malignant Glioma Cells Expressing Isocitrate Dehydrogenase 1 (IDH1) Mutant Protein: Dissecting the Mechanisms. Cancers (Basel) 2019; 11:cancers11060889. [PMID: 31242696 PMCID: PMC6627228 DOI: 10.3390/cancers11060889] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 06/09/2019] [Accepted: 06/11/2019] [Indexed: 01/02/2023] Open
Abstract
The presence of an isocitrate dehydrogenase 1 (IDH1) mutation is associated with a less aggressive phenotype, increased sensitivity to radiation, and increased overall survival in patients with diffuse glioma. Based on in vitro experimentations in malignant glioma cell lines, the consequences on cellular processes of IDH1R132H expression were analyzed. The results revealed that IDH1R132H expression enhanced the radiation induced accumulation of residual γH2AX foci and decreased the amount of glutathione (GSH) independent of the oxygen status. In addition, expression of the mutant IDH1 caused a significant increase of cell stiffness and induced an altered organization of the cytoskeleton, which has been shown to reinforce cell stiffness. Furthermore, IDH1R132H expression decreased the expression of vimentin, an important component of the cytoskeleton and regulator of the cell stiffness. The results emphasize the important role of mutant IDH1 in treatment of patients with diffuse gliomas especially in response to radiation. Hence, detection of the genetic status of IDH1 before therapy massively expands the utility of immunohistochemistry to accurately distinguish patients with a less aggressive and radiosensitive IDH1-mutant diffuse glioma suitable for radiotherapy from those with a more aggressive IDH1-wildtype diffuse glioma who might benefit from an individually intensified therapy comprising radiotherapy and alternative medical treatments.
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36
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Morshed RA, Young JS, Hervey-Jumper SL, Berger MS. The management of low-grade gliomas in adults. J Neurosurg Sci 2019; 63:450-457. [DOI: 10.23736/s0390-5616.19.04701-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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37
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Barzilai O, Ben Moshe S, Sitt R, Sela G, Shofty B, Ram Z. Improvement in cognitive function after surgery for low-grade glioma. J Neurosurg 2019; 130:426-434. [PMID: 29570009 DOI: 10.3171/2017.9.jns17658] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 09/05/2017] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Cognition is a key component in health-related quality of life (HRQoL) and is currently incorporated as a major parameter of outcome assessment in patients treated for brain tumors. The effect of surgery on cognition and HRQoL remains debatable. The authors investigated the impact of resection of low-grade gliomas (LGGs) on cognition and the correlation with various histopathological markers. METHODS A retrospective analysis of patients with LGG who underwent craniotomy for tumor resection at a single institution between 2010 and 2014 was conducted. Of 192 who underwent resective surgery for LGG during this period, 49 had complete pre- and postoperative neurocognitive evaluations and were included in the analysis. These patients completed a full battery of neurocognitive tests (memory, language, attention and working memory, visuomotor organization, and executive functions) pre- and postoperatively. Tumor and surgical characteristics were analyzed, including volumetric measurements and histopathological markers (IDH, p53, GFAP). RESULTS Postoperatively, significant improvement was found in memory and executive functions. A subgroup analysis of patients with dominant-side tumors, most of whom underwent intraoperative awake mapping, revealed significant improvement in the same domains. Patients whose tumors were on the nondominant side displayed significant improvement only in memory functions. Positive staining for p53 testing was associated with improved language function and greater extent of resection in dominant-side tumors. GFAP positivity was associated with improved memory in patients whose tumors were on the nondominant side. No correlation was found between cognitive outcome and preoperative tumor volume, residual volume, extent of resection, or IDH1 status. CONCLUSIONS Resection of LGG significantly improves memory and executive function and thus is likely to improve functional outcome in addition to providing oncological benefit. GFAP and pP53 positivity could possibly be associated with improved cognitive outcome. These data support early, aggressive, surgical treatment of LGG.
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Abstract
Gliomas are the most frequent intrinsic tumours of the central nervous system and encompass two principle subgroups: diffuse gliomas and gliomas showing a more circumscribed growth pattern ('nondiffuse gliomas'). In the revised fourth edition of the WHO Classification of CNS tumours published in 2016, classification of especially diffuse gliomas has fundamentally changed: for the first time, a large subset of these tumours is now defined based on presence/absence of IDH mutation and 1p/19q codeletion. Following this approach, the diagnosis of (anaplastic) oligoastrocytoma can be expected to largely disappear. Furthermore, in the WHO 2016 Classification gliomatosis cerebri is not an entity anymore but is now considered as a growth pattern. The most important changes in the very diverse group of 'nondiffuse' gliomas and neuronal-glial tumours are the introduction of anaplastic pleomorphic xanthoastrocytoma, of diffuse leptomeningeal glioneuronal tumour and of RELA fusion-positive ependymoma as entities. In the last part of this review, after very briefly touching upon classification of neuronal, choroid plexus and pineal region tumours, some practical implications and challenges associated with the WHO 2016 Classification of gliomas are discussed.
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Affiliation(s)
- P Wesseling
- Department of Pathology, Brain Tumor Center Amsterdam/VU University Medical Center, Amsterdam, The Netherlands.,Department of Pathology, Princess Máxima Center for Pediatric Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - D Capper
- Department of Neuropathology, Institute of Pathology, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany.,German Cancer Research Center (DKFZ), Clinical Cooperation Unit Neuropathology, German Cancer Consortium (DKTK), Heidelberg, Germany.,Charité -Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Neuropathology, Berlin, Germany
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Abstract
Incidence, prevalence, and survival for diffuse low-grade gliomas and diffuse anaplastic gliomas (including grade II and grade III astrocytomas and oligodendrogliomas) varies by histologic type, age at diagnosis, sex, and race/ethnicity. Significant progress has been made in identifying potential risk factors for glioma, although more research is warranted. The strongest risk factors that have been identified thus far include allergies/atopic disease, ionizing radiation, and heritable genetic factors. Further analysis of large, multicenter epidemiologic studies, and well-annotated "omic" datasets, can potentially lead to further understanding of the relationship between gene and environment in the process of brain tumor development.
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Affiliation(s)
- Luc Bauchet
- Department of Neurosurgery, Montpellier University Medical Center, National Institute for Health and Medical Research (INSERM), U1051, Hôpital Gui de Chauliac, Centre Hospitalo-Universitaire, 80 Avenue Augustin Fliche, Montpellier, France
| | - Quinn T Ostrom
- Department of Medicine, Section of Epidemiology and Population Sciences, Dan Duncan Comprehensive Cancer Center, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030-3498, USA.
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Hassanudin SA, Ponnampalam SN, Amini MN. Determination of genetic aberrations and novel transcripts involved in the pathogenesis of oligodendroglioma using array comparative genomic hybridization and next generation sequencing. Oncol Lett 2018; 17:1675-1687. [PMID: 30675227 PMCID: PMC6341554 DOI: 10.3892/ol.2018.9811] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 09/17/2018] [Indexed: 01/11/2023] Open
Abstract
The aim of the present study was to determine the genetic aberrations and novel transcripts, particularly the fusion transcripts, involved in the pathogenesis of low-grade and anaplastic oligodendroglioma. In the present study, tissue samples were obtained from patients with oligodendroglioma and additionally from archived tissue samples from the Brain Tumor Tissue Bank of the Brain Tumor Foundation of Canada. Six samples were obtained, three of which were low-grade oligodendroglioma and the other three anaplastic oligodendroglioma. DNA and RNA were extracted from each tissue sample. The resulting genomic DNA was then hybridized using the Agilent CytoSure 4×180K oligonucleotide array. Human reference DNA and samples were labeled using Cy3 cytidine 5′-triphosphate (CTP) and Cy5 CTP, respectively, while human Cot-1 DNA was used to reduce non-specific binding. Microarray-based comparative genomic hybridization data was then analyzed for genetic aberrations using the Agilent Cytosure Interpret software v3.4.2. The total RNA isolated from each sample was mixed with oligo dT magnetic beads to enrich for poly(A) mRNA. cDNAs were then synthesized and subjected to end-repair, poly(A) addition and connected using sequencing adapters using the Illumina TruSeq RNA Sample Preparation kit. The fragments were then purified and selected as templates for polymerase chain reaction amplification. The final library was constructed with fragments between 350–450 base pairs and sequenced using deep transcriptome sequencing on an Illumina HiSeq 2500 sequencer. The array comparative genomic hybridization revealed numerous amplifications and deletions on several chromosomes in all samples. However, the most interesting result was from the next generation sequencing, where one anaplastic oligodendroglioma sample was demonstrated to have five novel fusion genes that may potentially serve a critical role in tumor pathogenesis and progression.
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Affiliation(s)
- Siti A Hassanudin
- Cancer Research Center, Institute for Medical Research, Jalan Pahang, 50588 Kuala Lumpur, Malaysia
| | - Stephen N Ponnampalam
- Cancer Research Center, Institute for Medical Research, Jalan Pahang, 50588 Kuala Lumpur, Malaysia
| | - Muhammad N Amini
- Cancer Research Center, Institute for Medical Research, Jalan Pahang, 50588 Kuala Lumpur, Malaysia
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El Gueder D, Maatouk M, Kalboussi Z, Daouefi Z, Chaaban H, Ioannou I, Ghedira K, Ghedira LC, Luis J. Heat processing effect of luteolin on anti-metastasis activity of human glioblastoma cells U87. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2018; 25:36545-36554. [PMID: 30374718 DOI: 10.1007/s11356-018-3477-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 10/16/2018] [Indexed: 06/08/2023]
Abstract
Among the flavonoïds, luteolin is a flavone that has been identified in many plants. It is known for its apoptotic potential with damage to DNA and cell cycle blockage. Many studies have shown that luteolin has anti-oxidant, anti-inflammatory, and anti-cancer activities. However, it is known that heat treatment (boiling, cooking, and treating with microwaves …) can influence the structure of flavonoïds, which often leads to changes in their activities. The present study was conducted to study the effect of heated luteolin on anti-tumor activity of glioblastoma cells U87. Glioblastoma cell viability was evaluated by MTT assay. Adhesion assay was performed on different protein matrices (collagen type 1, vitronectin, fibronectin, and poly-L-lysine); migration assay was determined by modified Boyden chambers and videomicroscopy, and finally, angiogenesis was tested in vitro by capillary network formation on Matrigel™. The results obtained show that the thermal treatment significantly reduces its cytotoxic activity and ability to inhibit cell adhesion to different protein matrices. It was also found that the heat processed significantly reduced the ability of luteolin to inhibit cell migration, cell invasion, and endothelial cell angiogenesis (HMEC-1). This suggests that heat treated luteolin has a lower anti-tumor potential than native luteolin. Graphical abstract ᅟ.
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Affiliation(s)
- Dorra El Gueder
- Faculty of Sciences of Tunis, University of Tunis El Manar, 2092, Tunis, Tunisia.
- Faculty of Dental Medicine, Unity of Bioactive and Natural Substances and Biotechnology UR17ES49, University of Monastir, Avicenne Street, 5000, Monastir, Tunisia.
| | - Mouna Maatouk
- Faculty of Dental Medicine, Unity of Bioactive and Natural Substances and Biotechnology UR17ES49, University of Monastir, Avicenne Street, 5000, Monastir, Tunisia
| | - Zahar Kalboussi
- Faculty of Dental Medicine, Unity of Bioactive and Natural Substances and Biotechnology UR17ES49, University of Monastir, Avicenne Street, 5000, Monastir, Tunisia
| | - Zaineb Daouefi
- Faculty of Sciences of Tunis, University of Tunis El Manar, 2092, Tunis, Tunisia
- Faculty of Dental Medicine, Unity of Bioactive and Natural Substances and Biotechnology UR17ES49, University of Monastir, Avicenne Street, 5000, Monastir, Tunisia
| | - Hind Chaaban
- National School of Agronomy and Food Industries, Laboratory of Bimolecular Engineering, National Polytechnics Institute of Lorraine ENSAIA-INPL, 54505, Vandoeuvre les, Nancy, France
| | - Irina Ioannou
- National School of Agronomy and Food Industries, Laboratory of Bimolecular Engineering, National Polytechnics Institute of Lorraine ENSAIA-INPL, 54505, Vandoeuvre les, Nancy, France
| | - Kamel Ghedira
- Faculty of Pharmacy, Department of Pharmaceutical Sciences, University of Monastir, Avicenna Street, 5000, Monastir, Tunisia
| | - Leila Chekir Ghedira
- Faculty of Dental Medicine, Unity of Bioactive and Natural Substances and Biotechnology UR17ES49, University of Monastir, Avicenne Street, 5000, Monastir, Tunisia
| | - José Luis
- CNRS, Institut de Neurophysiopathologie, Aix Marseille University, Marseille, France
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DeWitt JC, Jordan JT, Frosch MP, Samore WR, Iafrate AJ, Louis DN, Lennerz JK. Cost-effectiveness of IDH testing in diffuse gliomas according to the 2016 WHO classification of tumors of the central nervous system recommendations. Neuro Oncol 2018; 19:1640-1650. [PMID: 29016871 DOI: 10.1093/neuonc/nox120] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Background Due to the decreasing prevalence of IDH1 mutations in older patients, the 2016 World Health Organization (WHO) classification of brain tumors proposed not to perform sequencing for isocitrate dehydrogenase (IDH) in glioblastoma patients ≥55 years old. We present a cost-effectiveness analysis to estimate the financial impact of these guidelines. Methods From 2010 to 2015 we performed 1023 IDH tests in gliomas, amounting to ~$1.09 million in direct laboratory test costs. Samples were tested using R132H-specific immunohistochemistry, DNA sequencing validated for detection of noncanonical IDH1/2 mutations, or both methods. Results In cases tested by DNA sequencing, the fraction of non-R132H mutations was 5.4%, which included only 2 high-grade gliomas in patients ≥55 years (0.9%). When remodeling the optimal age cutoff in our patient population using 5-year age-binning, we found a 10-times higher pretest probability for the presence of a noncanonical IDH1 mutation in the setting of a negative IDH1-R132H immunohistochemistry result in patients <55 years. Applying the independently confirmed age cutoff of 55 years to glioblastoma patients (64%) would result in $403200 saved (43%). By not performing sequencing in patients ≥55 years, the turn-around time to final integrated neuropathological diagnosis is reduced by 53%, allowing these patients to gain earlier benefits from personalized genomic medicine. Conclusion The negligible prevalence of noncanonical IDH mutations in glioblastoma patients ≥55 years argues against universal IDH sequencing in this population. We predict that adoption of this age-based sequencing cutoff recommendation from the 2016 WHO guidelines will result in significant cost and time savings throughout the global health care system.
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Affiliation(s)
- John C DeWitt
- Department of Pathology; Department of Neurology, Division of Neuro-Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Justin T Jordan
- Department of Pathology; Department of Neurology, Division of Neuro-Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Matthew P Frosch
- Department of Pathology; Department of Neurology, Division of Neuro-Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Wesley R Samore
- Department of Pathology; Department of Neurology, Division of Neuro-Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - A John Iafrate
- Department of Pathology; Department of Neurology, Division of Neuro-Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - David N Louis
- Department of Pathology; Department of Neurology, Division of Neuro-Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Jochen K Lennerz
- Department of Pathology; Department of Neurology, Division of Neuro-Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
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Mu L, Long Y, Yang C, Jin L, Tao H, Ge H, Chang YE, Karachi A, Kubilis PS, De Leon G, Qi J, Sayour EJ, Mitchell DA, Lin Z, Huang J. The IDH1 Mutation-Induced Oncometabolite, 2-Hydroxyglutarate, May Affect DNA Methylation and Expression of PD-L1 in Gliomas. Front Mol Neurosci 2018; 11:82. [PMID: 29643764 PMCID: PMC5882817 DOI: 10.3389/fnmol.2018.00082] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 03/01/2018] [Indexed: 01/25/2023] Open
Abstract
Background: Malignant gliomas are heterogeneous brain tumors with the potential for aggressive disease progression, as influenced by suppressive immunoediting. Given the success and enhanced potential of immune-checkpoint inhibitors in immunotherapy, we focused on the connections between genetic alterations affected by IDH1 mutations and immunological landscape changes and PDL-1 expression in gliomas. Methods: Paired surgically resected tumors from lower-grade gliomas (LGGs) and glioblastomas (GBM) were investigated, and a genetic analysis of patients' primary tumor samples culled from TCGA datasets was performed. Results: The results demonstrate that when compared with IDH1-mutant tumors, IDH1 wildtype tumors represent an immunosuppression landscape and elevated levels of PD-L1 expression. DNA hypo-methylation of the PD-L1 gene, as well as high gene and protein expressions, were observed in the wildtype tumors. We also found that quantitative levels of IDH1 mutant proteins were positively associated with recurrence-free survival (RFS). A key product of the IDH1 mutation (2-hydroxyglutarate) was found to transiently increase DNA methylation and suppress PD-L1 expression. Conclusions: IDH1 mutations impact the immune landscape of gliomas by affecting immune infiltrations and manipulating checkpoint ligand PD-L1 expression. Applications of immune checkpoint inhibitors may be beneficial for chemoradiation-insensitive IDH1-wildtype gliomas.
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Affiliation(s)
- Luyan Mu
- The Fourth Section of Department of Neurosurgery, The First Affiliated Hospital, Harbin Medical University, Harbin, China.,The First Section of Department of Neurosurgery, The Fourth Affiliated Hospital, Harbin Medical University, Harbin, China
| | - Yu Long
- The Fourth Section of Department of Neurosurgery, The First Affiliated Hospital, Harbin Medical University, Harbin, China.,Lillian S. Wells Department of Neurosurgery, University of Florida, Gainesville, FL, United States
| | - Changlin Yang
- Lillian S. Wells Department of Neurosurgery, University of Florida, Gainesville, FL, United States
| | - Linchun Jin
- The Fourth Section of Department of Neurosurgery, The First Affiliated Hospital, Harbin Medical University, Harbin, China.,Lillian S. Wells Department of Neurosurgery, University of Florida, Gainesville, FL, United States
| | - Haipeng Tao
- The Fourth Section of Department of Neurosurgery, The First Affiliated Hospital, Harbin Medical University, Harbin, China.,Lillian S. Wells Department of Neurosurgery, University of Florida, Gainesville, FL, United States
| | - Haitao Ge
- The Fourth Section of Department of Neurosurgery, The First Affiliated Hospital, Harbin Medical University, Harbin, China
| | - Yifan E Chang
- Lillian S. Wells Department of Neurosurgery, University of Florida, Gainesville, FL, United States
| | - Aida Karachi
- Lillian S. Wells Department of Neurosurgery, University of Florida, Gainesville, FL, United States
| | - Paul S Kubilis
- Lillian S. Wells Department of Neurosurgery, University of Florida, Gainesville, FL, United States
| | - Gabriel De Leon
- Lillian S. Wells Department of Neurosurgery, University of Florida, Gainesville, FL, United States
| | - Jiping Qi
- Department of Pathology, The First Affiliated Hospital, Harbin Medical University, Harbin, China
| | - Elias J Sayour
- Lillian S. Wells Department of Neurosurgery, University of Florida, Gainesville, FL, United States
| | - Duane A Mitchell
- Lillian S. Wells Department of Neurosurgery, University of Florida, Gainesville, FL, United States
| | - Zhiguo Lin
- The Fourth Section of Department of Neurosurgery, The First Affiliated Hospital, Harbin Medical University, Harbin, China
| | - Jianping Huang
- Lillian S. Wells Department of Neurosurgery, University of Florida, Gainesville, FL, United States
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44
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Molenaar RJ, Maciejewski JP, Wilmink JW, van Noorden CJF. Wild-type and mutated IDH1/2 enzymes and therapy responses. Oncogene 2018; 37:1949-1960. [PMID: 29367755 PMCID: PMC5895605 DOI: 10.1038/s41388-017-0077-z] [Citation(s) in RCA: 146] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 11/02/2017] [Accepted: 11/07/2017] [Indexed: 12/14/2022]
Abstract
Isocitrate dehydrogenase 1 and 2 (IDH1/2) are key enzymes in cellular metabolism, epigenetic regulation, redox states, and DNA repair. IDH1/2 mutations are causal in the development and/or progression of various types of cancer due to supraphysiological production of d-2-hydroxyglutarate. In various tumor types, IDH1/2-mutated cancers predict for improved responses to treatment with irradiation or chemotherapy. The present review discusses the molecular basis of the sensitivity of IDH1/2-mutated cancers with respect to the function of mutated IDH1/2 in cellular processes and their interactions with novel IDH1/2-mutant inhibitors. Finally, lessons learned from IDH1/2 mutations for future clinical applications in IDH1/2 wild-type cancers are discussed.
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Affiliation(s)
- Remco J Molenaar
- Cancer Center Amsterdam, Department of Medical Biology, Academic Medical Center, Amsterdam, The Netherlands. .,Cancer Center Amsterdam, Department of Medical Oncology, Academic Medical Center, Amsterdam, The Netherlands. .,Department of Translational Hematology and Oncology Research, Cleveland Clinic, Cleveland, OH, USA.
| | - Jaroslaw P Maciejewski
- Department of Translational Hematology and Oncology Research, Cleveland Clinic, Cleveland, OH, USA
| | - Johanna W Wilmink
- Cancer Center Amsterdam, Department of Medical Oncology, Academic Medical Center, Amsterdam, The Netherlands
| | - Cornelis J F van Noorden
- Cancer Center Amsterdam, Department of Medical Biology, Academic Medical Center, Amsterdam, The Netherlands
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45
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Kokelaar RF, Jones HG, Williamson J, Williams N, Griffiths AP, Beynon J, Jenkins GJ, Harris DA. DNA hypermethylation as a predictor of extramural vascular invasion (EMVI) in rectal cancer. Cancer Biol Ther 2018; 19:214-221. [PMID: 29260978 DOI: 10.1080/15384047.2017.1416933] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
PURPOSE DNA hypermethylation in gene promoter regions (CpG islands) is emerging as an important pathway in colorectal cancer tumourigenesis. Whilst genetic mutations have been associated with extramural vascular invasion (EMVI) in rectal cancer, no such association has yet been made with epigenetic factors. METHODS 100 consecutive neoadjuvant-naïve patients undergoing curative surgery for rectal were classified according to the presence or absence of EMVI on histopathological examination. DNA was extracted from tumours and subjected to bisulfite conversion and methylation-specific PCR to determine CIMP status (high, intermediate, or low; according to a validated panel of 8 genes). CIMP status was correlated with EMVI status, histopathological, clinical, and demographic variables, in addition to overall (OS) and disease free (DFS) survival. RESULTS 51 patients were characterised as CIMP-low, 48 CIMP-intermediate, and one patient CIMP-high. EMVI-positivity was associated with CIMP-intermediate epigenotype (p < 0.001). Patients with EMVI-positive tumours were found to have significantly more advanced disease by pT, pN, and pAJCC categorisation (p = 0.002, p < 0.001, and = p < 0.001, respectively). EMVI-positivity was significantly associated with the requirement for adjuvant chemotherapy (p < 0.001), and worse DFS but not OS (p = 0.012 and p = 0.052). CONCLUSIONS Given the association between CIMP-intermediate epigenotype and EMVI-positivity, and the subsequent disadvantage in pathological stage, requirement for adjuvant therapy and worse survival, tumour epigenotyping could potentially play an important role in personalising patients' cancer care. Further work is required to understand the mechanisms that underlie the observed effect, with the hope that they may provide novel opportunities for intervention and inform treatment decisions in rectal cancer.
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Affiliation(s)
- Rory F Kokelaar
- a Departments of Colorectal Surgery and Pathology , Abertawe Bro Morgannwg University Health Board , Swansea , Wales , United Kingdom.,c Cancer Biomarker Group, Institute of Life Science, School of Medicine, Swansea University , Swansea , Wales , United Kingdom
| | - Huw G Jones
- a Departments of Colorectal Surgery and Pathology , Abertawe Bro Morgannwg University Health Board , Swansea , Wales , United Kingdom
| | - Jeremy Williamson
- a Departments of Colorectal Surgery and Pathology , Abertawe Bro Morgannwg University Health Board , Swansea , Wales , United Kingdom
| | - Namor Williams
- b Pathology, Abertawe Bro Morgannwg University Health Board , Swansea , Wales , United Kingdom
| | - A Paul Griffiths
- b Pathology, Abertawe Bro Morgannwg University Health Board , Swansea , Wales , United Kingdom
| | - John Beynon
- a Departments of Colorectal Surgery and Pathology , Abertawe Bro Morgannwg University Health Board , Swansea , Wales , United Kingdom
| | - Gareth J Jenkins
- c Cancer Biomarker Group, Institute of Life Science, School of Medicine, Swansea University , Swansea , Wales , United Kingdom
| | - Dean A Harris
- a Departments of Colorectal Surgery and Pathology , Abertawe Bro Morgannwg University Health Board , Swansea , Wales , United Kingdom
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MRI Features and IDH Mutational Status of Grade II Diffuse Gliomas: Impact on Diagnosis and Prognosis. AJR Am J Roentgenol 2017; 210:621-628. [PMID: 29261348 DOI: 10.2214/ajr.17.18457] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Grade II diffuse gliomas (DGs) with isocitrate dehydrogenase (IDH) mutations are associated with better prognosis than their IDH wild-type counterparts. We sought to determine the MRI characteristics associated with IDH mutational status and ascertain whether MRI considered in combination with IDH mutational status can better predict the clinical outcomes of grade II DGs. MATERIALS AND METHODS Preoperative MRI examinations were retrospectively studied for qualitative tumor characteristics, including location, extent, cortical involvement, margin sharpness, cystic component, mineralization or hemorrhage, and contrast enhancement. Quantitative diffusion and perfusion metrics were also assessed. Logistic regression and ROC analyses were used to evaluate the relationship between MRI features and IDH mutational status. The association between IDH mutational status, 1p19q codeletion, MRI features, extent of resection, and clinical outcomes was assessed by Kaplan-Meier and Cox proportional hazards models. RESULTS Of 100 grade II DGs, 78 were IDH mutant and 22 were IDH wild type. IDH wild-type tumors were associated with older age, multifocality, brainstem involvement, lack of cystic change, and a lower apparent diffusion coefficient (ADC). Multivariable regression showed that age older than 45 years as well as low minimum ADC (ADCmin), mean ADC, and maximum ADC values were independently associated with IDH mutational status. Of these, an ADCmin threshold of 0.9 × 10-3 mm2/s or less provided the greatest sensitivity and specificity (91% and 76%, respectively) in defining IDH wild-type grade II DGs. Combining low ADCmin with IDH wild-type status conferred worse outcomes than did IDH wild-type status alone. CONCLUSION IDH wild-type grade II DGs are associated with a lower ADC and poor clinical outcomes. Combining IDH mutational status and ADC may allow more accurate prediction of clinical outcomes for patients with grade II DGs.
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Gene expression meta-analysis in diffuse low-grade glioma and the corresponding histological subtypes. Sci Rep 2017; 7:11741. [PMID: 28924174 PMCID: PMC5603565 DOI: 10.1038/s41598-017-12087-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 09/04/2017] [Indexed: 01/20/2023] Open
Abstract
Diffuse low-grade glioma (DLGG) is a well-differentiated, slow-growing tumour with an inherent tendency to progress to high-grade glioma. The potential roles of genetic alterations in DLGG development have not yet been fully delineated. Therefore, the current study performed an integrated gene expression meta-analysis of eight independent, publicly available microarray datasets including 291 DLGGs and 83 non-glioma (NG) samples to identify gene expression signatures associated with DLGG. Using INMEX, 708 differentially expressed genes (DEGs) (385 upregulated and 323 downregulated genes) were identified in DLGG compared to NG. Furthermore, 497 DEGs (222 upregulated and 275 downregulated genes) corresponding to two histological types were identified. Of these, high expression of HIP1R significantly correlated with increased overall survival, whereas high expression of TBXAS1 significantly correlated with decreased overall survival. Additionally, network-based meta-analysis identified FN1 and APP as the key hub genes in DLGG compared with NG. PTPN6 and CUL3 were the key hub genes identified in the astrocytoma relative to the oligodendroglioma. Further immunohistochemical validation revealed that MTHFD2 and SPARC were positively expressed in DLGG, whereas RBP4 was positively expressed in NG. These findings reveal potential molecular biomarkers for diagnosis and therapy in patients with DLGG and provide a rich and novel candidate reservoir for future studies.
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48
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A comprehensive review of paediatric low-grade diffuse glioma: pathology, molecular genetics and treatment. Brain Tumor Pathol 2017; 34:51-61. [DOI: 10.1007/s10014-017-0282-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 03/08/2017] [Indexed: 12/13/2022]
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49
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Cardona AF, Rojas L, Wills B, Behaine J, Jiménez E, Hakim F, Useche N, Bermúdez S, Arrieta O, Mejía JA, Ramón JF, Carranza H, Vargas C, Otero J, González D, Rodríguez J, Ortiz LD, Cifuentes H, Balaña C. Genotyping low-grade gliomas among Hispanics. Neurooncol Pract 2016; 3:164-172. [PMID: 31386063 DOI: 10.1093/nop/npv061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Indexed: 11/12/2022] Open
Abstract
Background Low-grade gliomas (LGGs) are classified by the World Health Organization as astrocytoma (DA), oligodendroglioma (OD), and mixed oligoastrocytoma (OA). TP53 mutation and 1p19q codeletion are the most-commonly documented molecular abnormalities. Isocitrate dehydrogenase (IDH) 1/2 mutations are frequent in LGGs; however, IDH-negative gliomas can also occur. Recent research suggests that ATRX plays a significant role in gliomagenesis. Methods We investigated p53 and Olig2 protein expression, and MGMT promoter methylation, 1p19q codeletion, IDH, and ATRX status in 63 Colombian patients with LGG. The overall survival (OS) rate was estimated and compared according to genotype. Results The most common histology was DA, followed by OD and OA. IDH1/2 mutations were found in 57.1% and MGMT+ (positive status of MGMT promoter methylation methyl-guanyl-methyl-transferase gene) in 65.1% of patients, while overexpression of p53 and Olig2 was present in 30.2% and 44.4%, respectively, and 1p19q codeletion in 34.9% of the patients. Overexpression of ATRX was analyzed in 25 patients, 16% tested positive and were also mutations in isocitrate dehydrogenase and negative 1p19q-codelition. The median follow-up was 15.8 months (95% CI, 7.6-42.0) and OS was 39.2 months (95% CI, 1.3-114). OS was positively and significantly affected by MGMT+, 1p19q codeletion, surgical intervention extent, and number of lobes involved. Multivariate analysis confirmed that MGMT methylation status and 1p19q codeletion affected OS. Conclusions This is the first study evaluating the molecular profile of Hispanic LGG patients. Findings confirmed the prognostic relevance of MGMT methylation and 1p19q codeletion, but do not support IDH1/2 mutation as a relevant marker. The latter may be explained by sample size and selection bias. ATRX alterations were limited to patients with DA and were mutations in isocitrate dehydrogenase and negative 1p19q-codelition.
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Affiliation(s)
- Andrés Felipe Cardona
- Clinical and Translational Oncology Group, Institute of Oncology, Clínica del Country, Bogotá, Colombia (A.F.C., H.C., C.V., J.O.); Foundation for Clinical and Applied Cancer Research- FICMAC, Bogotá, Colombia (A.F.C., B.W., H.C., C.V., J.O., J.R.); Institute of Neuroscience, Universidad El Bosque, Bogotá, Colombia (A.F.C., J.B., E.J., F.H., N.U., S.B., D.G.); Internal Medicicine Depatment, Universidad del Bosque-Fundación Santa Fe de Bogotá, Bogotá, Colombia (B.W.); Clinical Oncology Department, Centro Javeriano de Oncología, Hospital Universitario San Ignacio, Bogotá, Colombia (L.R.); Neurosurgery Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia (F.H., J.A.M., J.F.R., E.J.); Radiology Department, Division of Neuro-radiology, Fundación Santa Fe de Bogotá, Bogotá, Colombia (N.U., S.B.); Experimental Oncology Laboratory, Instituto Nacional de Cancerología (INCan), México City, México (O.A.); Clinical Oncology Department, Division of Neuro-Oncology, Clínica de Las Américas, Medellín, Colombia (L.D.O.); Neurosurgery Department, Clínica del Country, Bogotá, Colombia (H.C.); Medical Oncology Department, Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (C.B.)
| | - Leonardo Rojas
- Clinical and Translational Oncology Group, Institute of Oncology, Clínica del Country, Bogotá, Colombia (A.F.C., H.C., C.V., J.O.); Foundation for Clinical and Applied Cancer Research- FICMAC, Bogotá, Colombia (A.F.C., B.W., H.C., C.V., J.O., J.R.); Institute of Neuroscience, Universidad El Bosque, Bogotá, Colombia (A.F.C., J.B., E.J., F.H., N.U., S.B., D.G.); Internal Medicicine Depatment, Universidad del Bosque-Fundación Santa Fe de Bogotá, Bogotá, Colombia (B.W.); Clinical Oncology Department, Centro Javeriano de Oncología, Hospital Universitario San Ignacio, Bogotá, Colombia (L.R.); Neurosurgery Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia (F.H., J.A.M., J.F.R., E.J.); Radiology Department, Division of Neuro-radiology, Fundación Santa Fe de Bogotá, Bogotá, Colombia (N.U., S.B.); Experimental Oncology Laboratory, Instituto Nacional de Cancerología (INCan), México City, México (O.A.); Clinical Oncology Department, Division of Neuro-Oncology, Clínica de Las Américas, Medellín, Colombia (L.D.O.); Neurosurgery Department, Clínica del Country, Bogotá, Colombia (H.C.); Medical Oncology Department, Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (C.B.)
| | - Beatriz Wills
- Clinical and Translational Oncology Group, Institute of Oncology, Clínica del Country, Bogotá, Colombia (A.F.C., H.C., C.V., J.O.); Foundation for Clinical and Applied Cancer Research- FICMAC, Bogotá, Colombia (A.F.C., B.W., H.C., C.V., J.O., J.R.); Institute of Neuroscience, Universidad El Bosque, Bogotá, Colombia (A.F.C., J.B., E.J., F.H., N.U., S.B., D.G.); Internal Medicicine Depatment, Universidad del Bosque-Fundación Santa Fe de Bogotá, Bogotá, Colombia (B.W.); Clinical Oncology Department, Centro Javeriano de Oncología, Hospital Universitario San Ignacio, Bogotá, Colombia (L.R.); Neurosurgery Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia (F.H., J.A.M., J.F.R., E.J.); Radiology Department, Division of Neuro-radiology, Fundación Santa Fe de Bogotá, Bogotá, Colombia (N.U., S.B.); Experimental Oncology Laboratory, Instituto Nacional de Cancerología (INCan), México City, México (O.A.); Clinical Oncology Department, Division of Neuro-Oncology, Clínica de Las Américas, Medellín, Colombia (L.D.O.); Neurosurgery Department, Clínica del Country, Bogotá, Colombia (H.C.); Medical Oncology Department, Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (C.B.)
| | - José Behaine
- Clinical and Translational Oncology Group, Institute of Oncology, Clínica del Country, Bogotá, Colombia (A.F.C., H.C., C.V., J.O.); Foundation for Clinical and Applied Cancer Research- FICMAC, Bogotá, Colombia (A.F.C., B.W., H.C., C.V., J.O., J.R.); Institute of Neuroscience, Universidad El Bosque, Bogotá, Colombia (A.F.C., J.B., E.J., F.H., N.U., S.B., D.G.); Internal Medicicine Depatment, Universidad del Bosque-Fundación Santa Fe de Bogotá, Bogotá, Colombia (B.W.); Clinical Oncology Department, Centro Javeriano de Oncología, Hospital Universitario San Ignacio, Bogotá, Colombia (L.R.); Neurosurgery Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia (F.H., J.A.M., J.F.R., E.J.); Radiology Department, Division of Neuro-radiology, Fundación Santa Fe de Bogotá, Bogotá, Colombia (N.U., S.B.); Experimental Oncology Laboratory, Instituto Nacional de Cancerología (INCan), México City, México (O.A.); Clinical Oncology Department, Division of Neuro-Oncology, Clínica de Las Américas, Medellín, Colombia (L.D.O.); Neurosurgery Department, Clínica del Country, Bogotá, Colombia (H.C.); Medical Oncology Department, Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (C.B.)
| | - Enrique Jiménez
- Clinical and Translational Oncology Group, Institute of Oncology, Clínica del Country, Bogotá, Colombia (A.F.C., H.C., C.V., J.O.); Foundation for Clinical and Applied Cancer Research- FICMAC, Bogotá, Colombia (A.F.C., B.W., H.C., C.V., J.O., J.R.); Institute of Neuroscience, Universidad El Bosque, Bogotá, Colombia (A.F.C., J.B., E.J., F.H., N.U., S.B., D.G.); Internal Medicicine Depatment, Universidad del Bosque-Fundación Santa Fe de Bogotá, Bogotá, Colombia (B.W.); Clinical Oncology Department, Centro Javeriano de Oncología, Hospital Universitario San Ignacio, Bogotá, Colombia (L.R.); Neurosurgery Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia (F.H., J.A.M., J.F.R., E.J.); Radiology Department, Division of Neuro-radiology, Fundación Santa Fe de Bogotá, Bogotá, Colombia (N.U., S.B.); Experimental Oncology Laboratory, Instituto Nacional de Cancerología (INCan), México City, México (O.A.); Clinical Oncology Department, Division of Neuro-Oncology, Clínica de Las Américas, Medellín, Colombia (L.D.O.); Neurosurgery Department, Clínica del Country, Bogotá, Colombia (H.C.); Medical Oncology Department, Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (C.B.)
| | - Fernando Hakim
- Clinical and Translational Oncology Group, Institute of Oncology, Clínica del Country, Bogotá, Colombia (A.F.C., H.C., C.V., J.O.); Foundation for Clinical and Applied Cancer Research- FICMAC, Bogotá, Colombia (A.F.C., B.W., H.C., C.V., J.O., J.R.); Institute of Neuroscience, Universidad El Bosque, Bogotá, Colombia (A.F.C., J.B., E.J., F.H., N.U., S.B., D.G.); Internal Medicicine Depatment, Universidad del Bosque-Fundación Santa Fe de Bogotá, Bogotá, Colombia (B.W.); Clinical Oncology Department, Centro Javeriano de Oncología, Hospital Universitario San Ignacio, Bogotá, Colombia (L.R.); Neurosurgery Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia (F.H., J.A.M., J.F.R., E.J.); Radiology Department, Division of Neuro-radiology, Fundación Santa Fe de Bogotá, Bogotá, Colombia (N.U., S.B.); Experimental Oncology Laboratory, Instituto Nacional de Cancerología (INCan), México City, México (O.A.); Clinical Oncology Department, Division of Neuro-Oncology, Clínica de Las Américas, Medellín, Colombia (L.D.O.); Neurosurgery Department, Clínica del Country, Bogotá, Colombia (H.C.); Medical Oncology Department, Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (C.B.)
| | - Nicolás Useche
- Clinical and Translational Oncology Group, Institute of Oncology, Clínica del Country, Bogotá, Colombia (A.F.C., H.C., C.V., J.O.); Foundation for Clinical and Applied Cancer Research- FICMAC, Bogotá, Colombia (A.F.C., B.W., H.C., C.V., J.O., J.R.); Institute of Neuroscience, Universidad El Bosque, Bogotá, Colombia (A.F.C., J.B., E.J., F.H., N.U., S.B., D.G.); Internal Medicicine Depatment, Universidad del Bosque-Fundación Santa Fe de Bogotá, Bogotá, Colombia (B.W.); Clinical Oncology Department, Centro Javeriano de Oncología, Hospital Universitario San Ignacio, Bogotá, Colombia (L.R.); Neurosurgery Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia (F.H., J.A.M., J.F.R., E.J.); Radiology Department, Division of Neuro-radiology, Fundación Santa Fe de Bogotá, Bogotá, Colombia (N.U., S.B.); Experimental Oncology Laboratory, Instituto Nacional de Cancerología (INCan), México City, México (O.A.); Clinical Oncology Department, Division of Neuro-Oncology, Clínica de Las Américas, Medellín, Colombia (L.D.O.); Neurosurgery Department, Clínica del Country, Bogotá, Colombia (H.C.); Medical Oncology Department, Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (C.B.)
| | - Sonia Bermúdez
- Clinical and Translational Oncology Group, Institute of Oncology, Clínica del Country, Bogotá, Colombia (A.F.C., H.C., C.V., J.O.); Foundation for Clinical and Applied Cancer Research- FICMAC, Bogotá, Colombia (A.F.C., B.W., H.C., C.V., J.O., J.R.); Institute of Neuroscience, Universidad El Bosque, Bogotá, Colombia (A.F.C., J.B., E.J., F.H., N.U., S.B., D.G.); Internal Medicicine Depatment, Universidad del Bosque-Fundación Santa Fe de Bogotá, Bogotá, Colombia (B.W.); Clinical Oncology Department, Centro Javeriano de Oncología, Hospital Universitario San Ignacio, Bogotá, Colombia (L.R.); Neurosurgery Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia (F.H., J.A.M., J.F.R., E.J.); Radiology Department, Division of Neuro-radiology, Fundación Santa Fe de Bogotá, Bogotá, Colombia (N.U., S.B.); Experimental Oncology Laboratory, Instituto Nacional de Cancerología (INCan), México City, México (O.A.); Clinical Oncology Department, Division of Neuro-Oncology, Clínica de Las Américas, Medellín, Colombia (L.D.O.); Neurosurgery Department, Clínica del Country, Bogotá, Colombia (H.C.); Medical Oncology Department, Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (C.B.)
| | - Oscar Arrieta
- Clinical and Translational Oncology Group, Institute of Oncology, Clínica del Country, Bogotá, Colombia (A.F.C., H.C., C.V., J.O.); Foundation for Clinical and Applied Cancer Research- FICMAC, Bogotá, Colombia (A.F.C., B.W., H.C., C.V., J.O., J.R.); Institute of Neuroscience, Universidad El Bosque, Bogotá, Colombia (A.F.C., J.B., E.J., F.H., N.U., S.B., D.G.); Internal Medicicine Depatment, Universidad del Bosque-Fundación Santa Fe de Bogotá, Bogotá, Colombia (B.W.); Clinical Oncology Department, Centro Javeriano de Oncología, Hospital Universitario San Ignacio, Bogotá, Colombia (L.R.); Neurosurgery Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia (F.H., J.A.M., J.F.R., E.J.); Radiology Department, Division of Neuro-radiology, Fundación Santa Fe de Bogotá, Bogotá, Colombia (N.U., S.B.); Experimental Oncology Laboratory, Instituto Nacional de Cancerología (INCan), México City, México (O.A.); Clinical Oncology Department, Division of Neuro-Oncology, Clínica de Las Américas, Medellín, Colombia (L.D.O.); Neurosurgery Department, Clínica del Country, Bogotá, Colombia (H.C.); Medical Oncology Department, Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (C.B.)
| | - Juan Armando Mejía
- Clinical and Translational Oncology Group, Institute of Oncology, Clínica del Country, Bogotá, Colombia (A.F.C., H.C., C.V., J.O.); Foundation for Clinical and Applied Cancer Research- FICMAC, Bogotá, Colombia (A.F.C., B.W., H.C., C.V., J.O., J.R.); Institute of Neuroscience, Universidad El Bosque, Bogotá, Colombia (A.F.C., J.B., E.J., F.H., N.U., S.B., D.G.); Internal Medicicine Depatment, Universidad del Bosque-Fundación Santa Fe de Bogotá, Bogotá, Colombia (B.W.); Clinical Oncology Department, Centro Javeriano de Oncología, Hospital Universitario San Ignacio, Bogotá, Colombia (L.R.); Neurosurgery Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia (F.H., J.A.M., J.F.R., E.J.); Radiology Department, Division of Neuro-radiology, Fundación Santa Fe de Bogotá, Bogotá, Colombia (N.U., S.B.); Experimental Oncology Laboratory, Instituto Nacional de Cancerología (INCan), México City, México (O.A.); Clinical Oncology Department, Division of Neuro-Oncology, Clínica de Las Américas, Medellín, Colombia (L.D.O.); Neurosurgery Department, Clínica del Country, Bogotá, Colombia (H.C.); Medical Oncology Department, Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (C.B.)
| | - Juan Fernando Ramón
- Clinical and Translational Oncology Group, Institute of Oncology, Clínica del Country, Bogotá, Colombia (A.F.C., H.C., C.V., J.O.); Foundation for Clinical and Applied Cancer Research- FICMAC, Bogotá, Colombia (A.F.C., B.W., H.C., C.V., J.O., J.R.); Institute of Neuroscience, Universidad El Bosque, Bogotá, Colombia (A.F.C., J.B., E.J., F.H., N.U., S.B., D.G.); Internal Medicicine Depatment, Universidad del Bosque-Fundación Santa Fe de Bogotá, Bogotá, Colombia (B.W.); Clinical Oncology Department, Centro Javeriano de Oncología, Hospital Universitario San Ignacio, Bogotá, Colombia (L.R.); Neurosurgery Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia (F.H., J.A.M., J.F.R., E.J.); Radiology Department, Division of Neuro-radiology, Fundación Santa Fe de Bogotá, Bogotá, Colombia (N.U., S.B.); Experimental Oncology Laboratory, Instituto Nacional de Cancerología (INCan), México City, México (O.A.); Clinical Oncology Department, Division of Neuro-Oncology, Clínica de Las Américas, Medellín, Colombia (L.D.O.); Neurosurgery Department, Clínica del Country, Bogotá, Colombia (H.C.); Medical Oncology Department, Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (C.B.)
| | - Hernán Carranza
- Clinical and Translational Oncology Group, Institute of Oncology, Clínica del Country, Bogotá, Colombia (A.F.C., H.C., C.V., J.O.); Foundation for Clinical and Applied Cancer Research- FICMAC, Bogotá, Colombia (A.F.C., B.W., H.C., C.V., J.O., J.R.); Institute of Neuroscience, Universidad El Bosque, Bogotá, Colombia (A.F.C., J.B., E.J., F.H., N.U., S.B., D.G.); Internal Medicicine Depatment, Universidad del Bosque-Fundación Santa Fe de Bogotá, Bogotá, Colombia (B.W.); Clinical Oncology Department, Centro Javeriano de Oncología, Hospital Universitario San Ignacio, Bogotá, Colombia (L.R.); Neurosurgery Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia (F.H., J.A.M., J.F.R., E.J.); Radiology Department, Division of Neuro-radiology, Fundación Santa Fe de Bogotá, Bogotá, Colombia (N.U., S.B.); Experimental Oncology Laboratory, Instituto Nacional de Cancerología (INCan), México City, México (O.A.); Clinical Oncology Department, Division of Neuro-Oncology, Clínica de Las Américas, Medellín, Colombia (L.D.O.); Neurosurgery Department, Clínica del Country, Bogotá, Colombia (H.C.); Medical Oncology Department, Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (C.B.)
| | - Carlos Vargas
- Clinical and Translational Oncology Group, Institute of Oncology, Clínica del Country, Bogotá, Colombia (A.F.C., H.C., C.V., J.O.); Foundation for Clinical and Applied Cancer Research- FICMAC, Bogotá, Colombia (A.F.C., B.W., H.C., C.V., J.O., J.R.); Institute of Neuroscience, Universidad El Bosque, Bogotá, Colombia (A.F.C., J.B., E.J., F.H., N.U., S.B., D.G.); Internal Medicicine Depatment, Universidad del Bosque-Fundación Santa Fe de Bogotá, Bogotá, Colombia (B.W.); Clinical Oncology Department, Centro Javeriano de Oncología, Hospital Universitario San Ignacio, Bogotá, Colombia (L.R.); Neurosurgery Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia (F.H., J.A.M., J.F.R., E.J.); Radiology Department, Division of Neuro-radiology, Fundación Santa Fe de Bogotá, Bogotá, Colombia (N.U., S.B.); Experimental Oncology Laboratory, Instituto Nacional de Cancerología (INCan), México City, México (O.A.); Clinical Oncology Department, Division of Neuro-Oncology, Clínica de Las Américas, Medellín, Colombia (L.D.O.); Neurosurgery Department, Clínica del Country, Bogotá, Colombia (H.C.); Medical Oncology Department, Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (C.B.)
| | - Jorge Otero
- Clinical and Translational Oncology Group, Institute of Oncology, Clínica del Country, Bogotá, Colombia (A.F.C., H.C., C.V., J.O.); Foundation for Clinical and Applied Cancer Research- FICMAC, Bogotá, Colombia (A.F.C., B.W., H.C., C.V., J.O., J.R.); Institute of Neuroscience, Universidad El Bosque, Bogotá, Colombia (A.F.C., J.B., E.J., F.H., N.U., S.B., D.G.); Internal Medicicine Depatment, Universidad del Bosque-Fundación Santa Fe de Bogotá, Bogotá, Colombia (B.W.); Clinical Oncology Department, Centro Javeriano de Oncología, Hospital Universitario San Ignacio, Bogotá, Colombia (L.R.); Neurosurgery Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia (F.H., J.A.M., J.F.R., E.J.); Radiology Department, Division of Neuro-radiology, Fundación Santa Fe de Bogotá, Bogotá, Colombia (N.U., S.B.); Experimental Oncology Laboratory, Instituto Nacional de Cancerología (INCan), México City, México (O.A.); Clinical Oncology Department, Division of Neuro-Oncology, Clínica de Las Américas, Medellín, Colombia (L.D.O.); Neurosurgery Department, Clínica del Country, Bogotá, Colombia (H.C.); Medical Oncology Department, Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (C.B.)
| | - Diego González
- Clinical and Translational Oncology Group, Institute of Oncology, Clínica del Country, Bogotá, Colombia (A.F.C., H.C., C.V., J.O.); Foundation for Clinical and Applied Cancer Research- FICMAC, Bogotá, Colombia (A.F.C., B.W., H.C., C.V., J.O., J.R.); Institute of Neuroscience, Universidad El Bosque, Bogotá, Colombia (A.F.C., J.B., E.J., F.H., N.U., S.B., D.G.); Internal Medicicine Depatment, Universidad del Bosque-Fundación Santa Fe de Bogotá, Bogotá, Colombia (B.W.); Clinical Oncology Department, Centro Javeriano de Oncología, Hospital Universitario San Ignacio, Bogotá, Colombia (L.R.); Neurosurgery Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia (F.H., J.A.M., J.F.R., E.J.); Radiology Department, Division of Neuro-radiology, Fundación Santa Fe de Bogotá, Bogotá, Colombia (N.U., S.B.); Experimental Oncology Laboratory, Instituto Nacional de Cancerología (INCan), México City, México (O.A.); Clinical Oncology Department, Division of Neuro-Oncology, Clínica de Las Américas, Medellín, Colombia (L.D.O.); Neurosurgery Department, Clínica del Country, Bogotá, Colombia (H.C.); Medical Oncology Department, Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (C.B.)
| | - July Rodríguez
- Clinical and Translational Oncology Group, Institute of Oncology, Clínica del Country, Bogotá, Colombia (A.F.C., H.C., C.V., J.O.); Foundation for Clinical and Applied Cancer Research- FICMAC, Bogotá, Colombia (A.F.C., B.W., H.C., C.V., J.O., J.R.); Institute of Neuroscience, Universidad El Bosque, Bogotá, Colombia (A.F.C., J.B., E.J., F.H., N.U., S.B., D.G.); Internal Medicicine Depatment, Universidad del Bosque-Fundación Santa Fe de Bogotá, Bogotá, Colombia (B.W.); Clinical Oncology Department, Centro Javeriano de Oncología, Hospital Universitario San Ignacio, Bogotá, Colombia (L.R.); Neurosurgery Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia (F.H., J.A.M., J.F.R., E.J.); Radiology Department, Division of Neuro-radiology, Fundación Santa Fe de Bogotá, Bogotá, Colombia (N.U., S.B.); Experimental Oncology Laboratory, Instituto Nacional de Cancerología (INCan), México City, México (O.A.); Clinical Oncology Department, Division of Neuro-Oncology, Clínica de Las Américas, Medellín, Colombia (L.D.O.); Neurosurgery Department, Clínica del Country, Bogotá, Colombia (H.C.); Medical Oncology Department, Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (C.B.)
| | - León Darío Ortiz
- Clinical and Translational Oncology Group, Institute of Oncology, Clínica del Country, Bogotá, Colombia (A.F.C., H.C., C.V., J.O.); Foundation for Clinical and Applied Cancer Research- FICMAC, Bogotá, Colombia (A.F.C., B.W., H.C., C.V., J.O., J.R.); Institute of Neuroscience, Universidad El Bosque, Bogotá, Colombia (A.F.C., J.B., E.J., F.H., N.U., S.B., D.G.); Internal Medicicine Depatment, Universidad del Bosque-Fundación Santa Fe de Bogotá, Bogotá, Colombia (B.W.); Clinical Oncology Department, Centro Javeriano de Oncología, Hospital Universitario San Ignacio, Bogotá, Colombia (L.R.); Neurosurgery Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia (F.H., J.A.M., J.F.R., E.J.); Radiology Department, Division of Neuro-radiology, Fundación Santa Fe de Bogotá, Bogotá, Colombia (N.U., S.B.); Experimental Oncology Laboratory, Instituto Nacional de Cancerología (INCan), México City, México (O.A.); Clinical Oncology Department, Division of Neuro-Oncology, Clínica de Las Américas, Medellín, Colombia (L.D.O.); Neurosurgery Department, Clínica del Country, Bogotá, Colombia (H.C.); Medical Oncology Department, Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (C.B.)
| | - Hernando Cifuentes
- Clinical and Translational Oncology Group, Institute of Oncology, Clínica del Country, Bogotá, Colombia (A.F.C., H.C., C.V., J.O.); Foundation for Clinical and Applied Cancer Research- FICMAC, Bogotá, Colombia (A.F.C., B.W., H.C., C.V., J.O., J.R.); Institute of Neuroscience, Universidad El Bosque, Bogotá, Colombia (A.F.C., J.B., E.J., F.H., N.U., S.B., D.G.); Internal Medicicine Depatment, Universidad del Bosque-Fundación Santa Fe de Bogotá, Bogotá, Colombia (B.W.); Clinical Oncology Department, Centro Javeriano de Oncología, Hospital Universitario San Ignacio, Bogotá, Colombia (L.R.); Neurosurgery Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia (F.H., J.A.M., J.F.R., E.J.); Radiology Department, Division of Neuro-radiology, Fundación Santa Fe de Bogotá, Bogotá, Colombia (N.U., S.B.); Experimental Oncology Laboratory, Instituto Nacional de Cancerología (INCan), México City, México (O.A.); Clinical Oncology Department, Division of Neuro-Oncology, Clínica de Las Américas, Medellín, Colombia (L.D.O.); Neurosurgery Department, Clínica del Country, Bogotá, Colombia (H.C.); Medical Oncology Department, Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (C.B.)
| | - Carmen Balaña
- Clinical and Translational Oncology Group, Institute of Oncology, Clínica del Country, Bogotá, Colombia (A.F.C., H.C., C.V., J.O.); Foundation for Clinical and Applied Cancer Research- FICMAC, Bogotá, Colombia (A.F.C., B.W., H.C., C.V., J.O., J.R.); Institute of Neuroscience, Universidad El Bosque, Bogotá, Colombia (A.F.C., J.B., E.J., F.H., N.U., S.B., D.G.); Internal Medicicine Depatment, Universidad del Bosque-Fundación Santa Fe de Bogotá, Bogotá, Colombia (B.W.); Clinical Oncology Department, Centro Javeriano de Oncología, Hospital Universitario San Ignacio, Bogotá, Colombia (L.R.); Neurosurgery Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia (F.H., J.A.M., J.F.R., E.J.); Radiology Department, Division of Neuro-radiology, Fundación Santa Fe de Bogotá, Bogotá, Colombia (N.U., S.B.); Experimental Oncology Laboratory, Instituto Nacional de Cancerología (INCan), México City, México (O.A.); Clinical Oncology Department, Division of Neuro-Oncology, Clínica de Las Américas, Medellín, Colombia (L.D.O.); Neurosurgery Department, Clínica del Country, Bogotá, Colombia (H.C.); Medical Oncology Department, Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (C.B.)
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Feng F, Kuai D, Wang H, Li T, Miao W, Liu Y, Fan Y. Reduced expression of microRNA-497 is associated with greater angiogenesis and poor prognosis in human gliomas. Hum Pathol 2016; 58:47-53. [PMID: 27569294 DOI: 10.1016/j.humpath.2016.04.022] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2016] [Revised: 03/25/2016] [Accepted: 04/12/2016] [Indexed: 12/12/2022]
Abstract
MicroRNA (miR)-497 plays a tumor-suppressive role in several malignancies and is involved in glioma invasiveness and resistance to chemotherapy. To add to the knowledge of the clinical significance of miR-497 in human gliomas, quantitative real-time polymerase chain reaction was performed to detect the expression of miR-497 in 110 pairs of freshly prepared glioma and nonneoplastic brain tissues. Then the associations of miR-497 expression with various clinicopathological characteristics and overall survival of glioma patients were estimated statistically. Gain-of-function assays were also performed to examine the role of miR-497 in glioma angiogenesis. The expression of miR-497 in human glioma tissues was significantly lower than in nonneoplastic brain tissues (P<.001). In addition, low miR-497 expression was significantly associated with advanced World Health Organization grade (P<.001) and low Karnofsky performance scores (P=.02). Moreover, the survival of glioma patients with low miR-497 expression was dramatically shorter than that of patients with high miR-497 expression (P=.001). Forced expression of miR-497 in glioma cells inhibited tube formation by cocultured human brain microvascular endothelial cells. We also found that miR-497 overexpression in glioma cells led to decreased expression of vascular endothelial growth factor. In conclusion, miR-497 may be a favorable prognostic marker in human gliomas, in part by being a negative regulator of angiogenesis, implying its potential as a therapeutic target for this cancer.
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Affiliation(s)
- Fuqiang Feng
- Department of Neurosurgery, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, PR China
| | - Dong Kuai
- Department of Neurosurgery, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, PR China
| | - Hongqin Wang
- Department of Neurosurgery, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, PR China
| | - Tao Li
- Department of Neurosurgery, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, PR China
| | - Wang Miao
- Department of Neurosurgery, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, PR China
| | - Yueting Liu
- Department of Neurosurgery, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, PR China
| | - Yimin Fan
- Department of Neurosurgery, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, PR China.
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