Isocitrate Dehydrogenase 1/2 Wildtype Adult Astrocytoma with WHO Grade 2/3 Histological Features: Molecular Re-Classification, Prognostic Factors, Clinical Outcomes.

Autor:	Gupta M; Department of Radiotherapy, Guy's and St Thomas' NHS Foundation Trust, Great Maze Pond, London SE1 9RT, UK., Anjari M; Department of Radiology, Royal Free Hospital, Royal Free London NHS Foundation Trust, Pond Street, London NW3 2QG, UK.; Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, Queen Square, London WC1N 3BG, UK.; Department of Brain Rehabilitation and Repair, Institute of Neurology, University College London, Queen Square, London WC1N 3BG, UK., Brandner S; Division of Neuropathology, University College London Hospitals NHS Foundation Trust, Queen Square, London WC1N 3BG, UK.; Department of Neurodegenerative Diseases, Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK., Fersht N; Department of Radiotherapy, University College London NHS Foundation Trust, 250 Euston Rd, London NW1 2PG, UK., Wilson E; Department of Radiotherapy, University College London NHS Foundation Trust, 250 Euston Rd, London NW1 2PG, UK., Thust S; Department of Brain Rehabilitation and Repair, Institute of Neurology, University College London, Queen Square, London WC1N 3BG, UK.; Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham NG7 2RD, UK.; Queens Medical Centre, Nottingham University NHS Trust, Nottingham NG7 2UH, UK., Kosmin M; Department of Radiotherapy, University College London NHS Foundation Trust, 250 Euston Rd, London NW1 2PG, UK.; NIHR Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London W1T 7DN, UK.
Jazyk:	angličtina
Zdroj:	Biomedicines [Biomedicines] 2024 Apr 18; Vol. 12 (4). Date of Electronic Publication: 2024 Apr 18.
DOI:	10.3390/biomedicines12040901
Abstrakt:	Background: Isocitrate Dehydrogenase 1/2 (IDH 1/2)-wildtype (WT) astrocytomas constitute a heterogeneous group of tumors and have undergone a series of diagnostic reclassifications over time. This study aimed to investigate molecular markers, clinical, imaging, and treatment factors predictive of outcomes in WHO grade 2/3 IDH-WT astrocytomas ('early glioblastoma'). Methodology: Patients with WHO grade 2/3 IDH-WT astrocytomas were identified from the hospital archives. They were cross-referenced with the electronic medical records systems, including neuroimaging. The expert neuro-pathology team retrieved data on molecular markers-MGMT, TERT , IDH, and EGFR . Tumors with a TERT mutation and/or EGFR amplification were reclassified as glioblastoma. Results: Fifty-four patients were identified. Sixty-three percent of the patients could be conclusively reclassified as glioblastoma based on either TERT mutation, EGFR amplification, or both. On imaging, 65% showed gadolinium enhancement on MRI. Thirty-nine patients (72%) received long-course radiotherapy, of whom 64% received concurrent chemotherapy. The median follow-up of the group was 16 months (range: 2-90), and the median overall survival (OS) was 17.3 months. The 2-year OS of the whole cohort was 31%. On univariate analysis, older age, worse performance status (PS), and presence versus absence of contrast enhancement on diagnostic MRI were statistically significant for poorer OS. Conclusion: IDH-WT WHO grade 2/3 astrocytomas are a heterogeneous group of tumors with poor clinical outcomes. The majority can be reclassified as glioblastoma, based on current WHO classification criteria, but further understanding of the underlying biology of these tumors and the discovery of novel targeted agents are needed for better outcomes. Competing Interests: The authors declare no conflict of interest.
Databáze:	MEDLINE
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