Radiological Evaluation of Newly Diagnosed Non-Brainstem Pediatric High-Grade Glioma in the HERBY Phase II Trial.

Autor:	Rodriguez Gutierrez D; Medical Physics and Clinical Engineering, Nottingham University Hospital Trust, Nottingham, United Kingdom. cabovidio@gmail.com.; Division of Clinical Neuroscience, University of Nottingham, Nottingham, United Kingdom., Jones C; Divisions of Molecular Pathology and Cancer Therapeutics, The Institute of Cancer Research, London, United Kingdom., Varlet P; Anatomie et cytologie pathologiques, Centre Hospitalier Sainte Anne, Paris, France., Mackay A; Divisions of Molecular Pathology and Cancer Therapeutics, The Institute of Cancer Research, London, United Kingdom., Warren D; Department of Radiology, Leeds Teaching Hospitals, Leeds, United Kingdom., Warmuth-Metz M; Institute for Diagnostic and Interventional Neuroradiology, Würzburg University, Würzburg, Germany., Aliaga ES; Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, the Netherlands., Calmon R; Pediatric Radiology, Necker Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France., Hargrave DR; Haematology and Oncology Department, Great Ormond Street Hospital, London, United Kingdom., Cañete A; Pediatric Oncology and Hematology Unit, Hospital La Fe, Valencia, Spain., Massimino M; Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy., Azizi AA; Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Medical University of Vienna, Vienna, Austria., Le Deley MC; Pediatric and Adolescent Oncology and Unite Mixte de Recherche, Gustave Roussy, Université Paris-Saclay, Université Paris-Sud, Villejuif, France., Saran F; Neuro-oncology Unit, Royal Marsden Hospital, London, United Kingdom., Rousseau RF; F. Hoffmann-La Roche, Basel, Switzerland., Zahlmann G; F. Hoffmann-La Roche, Basel, Switzerland., Garcia J; F. Hoffmann-La Roche, Basel, Switzerland., Vassal G; Pediatric and Adolescent Oncology and Unite Mixte de Recherche, Gustave Roussy, Université Paris-Saclay, Université Paris-Sud, Villejuif, France., Grill J; Pediatric and Adolescent Oncology and Unite Mixte de Recherche, Gustave Roussy, Université Paris-Saclay, Université Paris-Sud, Villejuif, France., Morgan PS; Medical Physics and Clinical Engineering, Nottingham University Hospital Trust, Nottingham, United Kingdom.; Division of Clinical Neuroscience, University of Nottingham, Nottingham, United Kingdom., Jaspan T; Department of Radiology, Nottingham University Hospital Trust, Nottingham, United Kingdom.
Jazyk:	angličtina
Zdroj:	Clinical cancer research : an official journal of the American Association for Cancer Research [Clin Cancer Res] 2020 Apr 15; Vol. 26 (8), pp. 1856-1865. Date of Electronic Publication: 2020 Jan 10.
DOI:	10.1158/1078-0432.CCR-19-3154
Abstrakt:	Purpose: The HERBY trial evaluated the benefit of the addition of the antiangiogenic agent Bevacizumab (BEV) to radiotherapy/temozolomide (RT/TMZ) in pediatric patients with newly diagnosed non-brainstem high-grade glioma (HGG). The work presented here aims to correlate imaging characteristics and outcome measures with pathologic and molecular data. Experimental Design: Radiological, pathologic, and molecular data were correlated with trial clinical information to retrospectively re-evaluate event-free survival (EFS) and overall survival (OS). Results: One-hundred thirteen patients were randomized to the RT/TMZ arm ( n = 54) or the RT/TMZ+BEV (BEV arm; n = 59). The tumor arose in the cerebral hemispheres in 68 patients (Cerebral group) and a midline location in 45 cases (Midline group). Pathologic diagnosis was available in all cases and molecular data in 86 of 113. H3 K27M histone mutations were present in 23 of 32 Midline cases and H3 G34R/V mutations in 7 of 54 Cerebral cases. Total/near-total resection occurred in 44 of 68 (65%) Cerebral cases but in only 5 of 45 (11%) Midline cases ( P < 0.05). Leptomeningeal metastases (27 cases, 13 with subependymal spread) at relapse were more frequent in Midline (17/45) than in Cerebral tumors (10/68, P < 0.05). Mean OS (14.1 months) and EFS (9.0 months) in Midline tumors were significantly lower than mean OS (20.7 months) and EFS (14.9 months) in Cerebral tumors ( P < 0.05). Pseudoprogression occurred in 8 of 111 (6.2%) cases. Conclusions: This study has shown that the poor outcome of midline tumors (compared with cerebral) may be related to (1) lesser surgical resection, (2) H3 K27M histone mutations, and (3) higher leptomeningeal dissemination. (©2020 American Association for Cancer Research.)
Databáze:	MEDLINE
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