Brain Tumor Epidemiology - A Hub within Multidisciplinary Neuro-oncology. Report on the 15th Brain Tumor Epidemiology Consortium (BTEC) Annual Meeting, Vienna, 2014

Construction of the National Brain Tumor Registry of China for better management and more efficient use of data: a protocol

INTRODUCTION

Brain tumours encompass a complex group of intracranial tumours that mostly affect young adults and children, with a high incidence rate and poor prognosis. It remains impossible to systematically collect data on patients with brain tumours in China and difficult to perform in-depth analysis on the status of brain tumours, medical outcomes or other important medical issues through a multicentre clinical study. This study describes the first nation-wide data platform including the entire spectrum of brain tumour entities, which will allow better management and more efficient application of patient data in China.

METHODS AND ANALYSIS

The National Brain Tumor Registry of China (NBTRC) is a registry of real-word clinical data on brain tumours. It is established and managed by the China National Clinical Research Center for Neurological Diseases and administered by its scientific and executive committees. The 54 participating hospitals of the NBTRC are located in 27 provinces/municipalities, performing more than 40 000 brain tumour surgeries per year. The data consist of in-hospital medical records, images and follow-up information after discharge. Data can be uploaded in three ways: the web portal, remote physical servers and offline software. The data quality control scheme is seven-dimensional. Each participating hospital could focus on a single pathology subtype and public subtypes of brain tumour for which they expect to conduct related multicentre clinical research. The standardised workflow to conduct clinical research is based on the benefit-sharing mechanism. Data collection will be conducted continuously from 1 February 2019 to 31 January 2024.

ETHICS AND DISSEMINATION

Informed consent will be obtained from all participants. Consent for the adolescents' participation will be also obtained from their guardians via written consent. The results will be published in professional journals, in both Chinese and English.

TRIAL REGISTRATION NUMBER

Chinese Clinical Trial Registry (ChiCTR1900021096).

[IDH1- and IDH2-mutations in brain glial tumors - the new antioncogenic mechanism]

Mutant forms of the gene IDH1 progress significantly slower, have a lower risk of neoplastic transformation, and generally, mutations of this gene have a pronounced anti-oncogenic effect. At the same time, almost all mutations are quite stereotyped (98,9%) and occur in the same region of the gene - R132H mutations. IDH1 gene mutations is a complex multi-layered process, which is a completely new, not previously described anti-oncogene activation mechanism of intracellular protection. The reason that there is a mutation in the tumor cells is associated with de novo blocking differentiation processes and development of brain cells in the development process, as evidenced by severe cerebral hypoplasia in patients with congenital forms of this mutation. A completely new mechanism of antitumor protection has been described - stereotypical IDH1 gene mutation is a gene, in fact, is a key event, causing a cascade of further anti-oncogenic mechanisms in brain gliomas.

Rehabilitation of motor dysfunction in primary brain tumor patients†

In 2010 it was estimated that >688 000 Americans were living with a primary brain tumor (PBT) corresponding to a U.S. prevalence rate of approximately 221.8 per 100 000 people. Five-year survival is 96.1% in nonmalignant PBTs, 34% in malignant PBTs for all ages, and 71% in children [1985-2005]. Case fatality rates have decreased in the U.S. since the 1970's for nonmalignant PBTs and for medulloblastoma, oligodendroglioma, and astrocytoma. Statistics of increasing survival highlight the importance of rehabilitation interventions to improve function and quality of life in survivors. PBT motor dysfunction is multifactorial, occurring as a result of direct effects of tumor and/or swelling or as a result of treatments; etiologies include encephalopathy, myopathy, neuropathy, infection, poor nutrition, metabolic factors, emotional factors, impaired perception/vision/cognition and complications of immobility. Motor dysfunction may lead to: impaired mobility, impaired activities of daily living, risk for complications of immobility, falls, pain, anxiety/depression, and loss of functional independence and quality of life. Rehabilitation treatment strategies target specific causes of motor dysfunction to improve functional independence and quality of life. This article reviews current knowledge and controversy regarding the role of rehabilitation for motor disorders in PBT patients.

Different pediatric brain tumors are associated with different gene expression profiling

Malignant brain tumors are the most common pediatric solid tumors and are the leading cause of death from childhood cancers. These tumors include several histologic subtypes. Due to the particular properties of brain tumors, such as growth and division, examination of brain tumors and the analysis of results are not simple. Up to date there is a dearth of useful biomarkers that have been validated and clinically implemented for pediatric brain tumors. In order to identify the new genetic alterations we recognized, using microarray dataset, chitinases as new potential biomarkers of CNS tumors. The modulation of chitinases was confirmed also in the different histologic subtypes. Our study revealed that distinct patterns of chitinases expression characterize the diverse histological subtypes. In addition evaluating other lisosomal enzymes such as glycosidases and proteases we found that NEU4, CTBS and GBA2 belonging to glycosidases family and CTSC, CTSK and CTSF belonging to proteases family were differently modulated. Future investigations are needed to be performed before some of these enzymes could finally be used as biomarkers of specific types of CNS neoplasms.