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Blobner J, Dengler L, Blobner S, Eberle C, Weller J, Teske N, Karschnia P, Rühlmann K, Heinrich K, Ziemann F, Greif PA, Jeremias I, Wuerstlein R, Hasselmann K, Dorostkar M, Harter PN, Quach S, Stoecklein V, Albert NL, Niyazi M, Tonn JC, Thon N, Christoph Westphalen B, von Baumgarten L. Significance of molecular diagnostics for therapeutic decision-making in recurrent glioma. Neurooncol Adv 2023; 5:vdad060. [PMID: 37287694 PMCID: PMC10243988 DOI: 10.1093/noajnl/vdad060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023] Open
Abstract
Background Targeted therapies have substantially improved survival in cancer patients with malignancies outside the brain. Whether in-depth analysis for molecular alterations may also offer therapeutic avenues in primary brain tumors remains unclear. We herein present our institutional experience for glioma patients discussed in our interdisciplinary molecular tumor board (MTB) implemented at the Comprehensive Cancer Center Munich (LMU). Methods We retrospectively searched the database of the MTB for all recurrent glioma patients after previous therapy. Recommendations were based on next-generation sequencing results of individual patient's tumor tissue. Clinical and molecular information, previous therapy regimens, and outcome parameters were collected. Results Overall, 73 consecutive recurrent glioma patients were identified. In the median, advanced molecular testing was initiated with the third tumor recurrence. The median turnaround time between initiation of molecular profiling and MTB case discussion was 48 ± 75 days (range: 32-536 days). Targetable mutations were found for 50 recurrent glioma patients (68.5%). IDH1 mutation (27/73; 37%), epidermal growth factor receptor amplification (19/73; 26%), and NF1 mutation (8/73; 11%) were the most detected alterations and a molecular-based treatment recommendation could be made for all of them. Therapeutic recommendations were implemented in 12 cases (24%) and one-third of these heavily pretreated patients experienced clinical benefit with at least disease stabilization. Conclusions In-depth molecular analysis of tumor tissue may guide targeted therapy also in brain tumor patients and considerable antitumor effects might be observed in selected cases. However, future studies to corroborate our results are needed.
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Affiliation(s)
- Jens Blobner
- Jens Blobner, MD, Department of Neurosurgery, Division of Neuro-Oncology, Ludwigs Maximilians University School of Medicine, 81377 Munich, Germany ()
| | - Laura Dengler
- Department of Neurosurgery, LMU University Hospital, Ludwig Maximilians University (LMU), Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, Germany
| | - Sven Blobner
- MedicalFaculty Heidelberg, University of Heidelberg, Heidelburg, Germany
| | - Constantin Eberle
- Department of Neurosurgery, LMU University Hospital, Ludwig Maximilians University (LMU), Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, Germany
| | - Jonathan Weller
- Department of Neurosurgery, LMU University Hospital, Ludwig Maximilians University (LMU), Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, Germany
| | - Nico Teske
- Department of Neurosurgery, LMU University Hospital, Ludwig Maximilians University (LMU), Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, Germany
| | - Philipp Karschnia
- Department of Neurosurgery, LMU University Hospital, Ludwig Maximilians University (LMU), Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, Germany
| | - Katharina Rühlmann
- Comprehensive Cancer Center München (CCC München), LMU University Hospital, Ludwig Maximilians University (LMU), Munich, Germany
| | - Kathrin Heinrich
- Department of Medicine, Hematology and Oncology Division and Cellular Immunotherapy Program, LMU University Hospital, Ludwig Maximilians University (LMU), Munich, Germany
| | - Frank Ziemann
- Department of Medicine, Hematology and Oncology Division and Cellular Immunotherapy Program, LMU University Hospital, Ludwig Maximilians University (LMU), Munich, Germany
| | - Philipp A Greif
- Department of Medicine, Hematology and Oncology Division and Cellular Immunotherapy Program, LMU University Hospital, Ludwig Maximilians University (LMU), Munich, Germany
| | - Irmela Jeremias
- German Cancer Consortium (DKTK), Partner Site Munich, Germany
- Dr. von Haunersches Children Hospital, LMU University Hospital, Ludwig Maximilians University (LMU), Munich, Germany
| | - Rachel Wuerstlein
- Department of Obstetrics and Gynecology and CCC Munich LMU University Hospital, Ludwig Maximilians University (LMU), Munich, Germany
| | - Korbinian Hasselmann
- German Cancer Consortium (DKTK), Partner Site Munich, Germany
- Department of Medicine, Hematology and Oncology Division and Cellular Immunotherapy Program, LMU University Hospital, Ludwig Maximilians University (LMU), Munich, Germany
- Comprehensive Cancer Center München (CCC München), LMU University Hospital, Ludwig Maximilians University (LMU), Munich, Germany
| | - Mario Dorostkar
- German Cancer Consortium (DKTK), Partner Site Munich, Germany
- Comprehensive Cancer Center München (CCC München), LMU University Hospital, Ludwig Maximilians University (LMU), Munich, Germany
- Center for Neuropathology and Prion Research, LMU University Hospital, Ludwig Maximilians University (LMU), Munich, Germany
| | - Patrick N Harter
- German Cancer Consortium (DKTK), Partner Site Munich, Germany
- Comprehensive Cancer Center München (CCC München), LMU University Hospital, Ludwig Maximilians University (LMU), Munich, Germany
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany
| | - Stefanie Quach
- Department of Neurosurgery, LMU University Hospital, Ludwig Maximilians University (LMU), Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, Germany
| | - Veit Stoecklein
- Department of Neurosurgery, LMU University Hospital, Ludwig Maximilians University (LMU), Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, Germany
| | - Nathalie L Albert
- Department of Nuclear Medicine, LMU University Hospital, Ludwig Maximilians University (LMU), Munich, Germany
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany
| | - Maximilian Niyazi
- Department of Radiation Oncology, LMU University Hospital, Ludwig Maximilians University (LMU), Munich, Germany
| | - Joerg-Christian Tonn
- Department of Neurosurgery, LMU University Hospital, Ludwig Maximilians University (LMU), Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, Germany
| | - Niklas Thon
- Department of Neurosurgery, LMU University Hospital, Ludwig Maximilians University (LMU), Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, Germany
| | - Benedikt Christoph Westphalen
- German Cancer Consortium (DKTK), Partner Site Munich, Germany
- Department of Medicine, Hematology and Oncology Division and Cellular Immunotherapy Program, LMU University Hospital, Ludwig Maximilians University (LMU), Munich, Germany
- Comprehensive Cancer Center München (CCC München), LMU University Hospital, Ludwig Maximilians University (LMU), Munich, Germany
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany
| | - Louisa von Baumgarten
- Corresponding Authors: Louisa von Baumgarten, MD, Department of Neurosurgery, Division of Neuro-Oncology, Ludwig Maximilians University School of Medicine, 81377 Munich, Germany ()
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