A molecularly integrated grade for meningioma.

Autor:	Driver J; Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA., Hoffman SE; Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.; Harvard-MIT Program in Health Science Technology, MD-PhD Program, Harvard Medical School, Boston, Massachusetts, USA., Tavakol S; Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA., Woodward E; Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA., Maury EA; Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.; Harvard-MIT Program in Health Science Technology, MD-PhD Program, Harvard Medical School, Boston, Massachusetts, USA.; Bioinformatics and Integrative Genomics Program, Harvard Medical School, Boston, Massachusetts, USA., Bhave V; Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA., Greenwald NF; Cancer Biology Program, Stanford University School of Medicine, Stanford, California, USA., Nassiri F; Department of Neurosurgery, University of Toronto, Toronto, Ontario, Canada., Aldape K; National Cancer Institute, Bethesda, Maryland, USA., Zadeh G; Department of Neurosurgery, University of Toronto, Toronto, Ontario, Canada., Choudhury A; Departments of Radiation Oncology and Neurological Surgery, University of California San Francisco, San Francisco, California, USA., Vasudevan HN; Departments of Radiation Oncology and Neurological Surgery, University of California San Francisco, San Francisco, California, USA., Magill ST; Departments of Radiation Oncology and Neurological Surgery, University of California San Francisco, San Francisco, California, USA., Raleigh DR; Departments of Radiation Oncology and Neurological Surgery, University of California San Francisco, San Francisco, California, USA., Abedalthagafi M; King Fahad Medical City and King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia., Aizer AA; Department of Radiation Oncology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA., Alexander BM; Department of Radiation Oncology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA., Ligon KL; Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA., Reardon DA; Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA., Wen PY; Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA., Al-Mefty O; Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA., Ligon AH; Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA., Dubuc AM; Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA., Beroukhim R; Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.; Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.; Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA., Claus EB; Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.; Yale School of Public Health, New Haven, Connecticut, USA., Dunn IF; Department of Neurosurgery, Oklahoma University Medical Center, Oklahoma City, Oklahoma, USA., Santagata S; Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA., Bi WL; Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.; Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.
Jazyk:	angličtina
Zdroj:	Neuro-oncology [Neuro Oncol] 2022 May 04; Vol. 24 (5), pp. 796-808.
DOI:	10.1093/neuonc/noab213
Abstrakt:	Background: Meningiomas are the most common primary intracranial tumor in adults. Clinical care is currently guided by the World Health Organization (WHO) grade assigned to meningiomas, a 3-tiered grading system based on histopathology features, as well as extent of surgical resection. Clinical behavior, however, often fails to conform to the WHO grade. Additional prognostic information is needed to optimize patient management. Methods: We evaluated whether chromosomal copy-number data improved prediction of time-to-recurrence for patients with meningioma who were treated with surgery, relative to the WHO schema. The models were developed using Cox proportional hazards, random survival forest, and gradient boosting in a discovery cohort of 527 meningioma patients and validated in 2 independent cohorts of 172 meningioma patients characterized by orthogonal genomic platforms. Results: We developed a 3-tiered grading scheme (Integrated Grades 1-3), which incorporated mitotic count and loss of chromosome 1p, 3p, 4, 6, 10, 14q, 18, 19, or CDKN2A. 32% of meningiomas reclassified to either a lower-risk or higher-risk Integrated Grade compared to their assigned WHO grade. The Integrated Grade more accurately identified meningioma patients at risk for recurrence, relative to the WHO grade, as determined by time-dependent area under the curve, average precision, and the Brier score. Conclusion: We propose a molecularly integrated grading scheme for meningiomas that significantly improves upon the current WHO grading system in prediction of progression-free survival. This framework can be broadly adopted by clinicians with relative ease using widely available genomic technologies and presents an advance in the care of meningioma patients. (© The Author(s) 2021. Published by Oxford University Press on behalf of the Society for Neuro-Oncology.)
Databáze:	MEDLINE
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