Contemporary Prognostic Signatures and Refined Risk Stratification of Gliomas: An Analysis of 4,400 Tumors.

Autor:	Ghosh HS; Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts., Patel RV; Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts., Woodward E; Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts., Greenwald NF; Stanford University, Palo Alto, California., Bhave VM; Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts., Maury EA; Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.; Harvard/MIT MD-PhD Program, Harvard Medical School, Boston, MA, USA., Cello G; Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts., Hoffman SE; Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts., Li Y; Broad Institute of Harvard and MIT, Cambridge, Massachusetts.; Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts., Gupta H; Broad Institute of Harvard and MIT, Cambridge, Massachusetts.; Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts., Youssef G; Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts., Spurr LF; Department of Radiation and Cellular Oncology, University of Chicago Pritzker School of Medicine, Chicago, Illinois., Vogelzang J; Department of Pathology, Dana-Farber Cancer Institute, Boston, Massachusetts., Touat M; Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.; Department of Neurology, Brigham and Women's Hospital, Boston, Massachusetts.; Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie 2-Mazarin, Paris, France., Dubois F; Broad Institute of Harvard and MIT, Cambridge, Massachusetts.; Division of Cancer Biology, Dana-Farber Cancer Institute, Boston, Massachusetts., Cherniack AD; Broad Institute of Harvard and MIT, Cambridge, Massachusetts.; Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts., Guo X; Department of Neurosurgery, Peking Union Medical College Hospital, Beijing, China., Tavakol S; Department of Pathology, Dana-Farber Cancer Institute, Boston, Massachusetts.; Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma., Cioffi G; Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland., Lindeman NI; Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts., Ligon AH; Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts., Chiocca EA; Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts., Reardon DA; Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts., Wen PY; Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts., Meredith D; Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts., Santagata S; Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts., Barnholtz-Sloan JS; Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland.; Center for Biomedical Informatics and Information Technology, National Cancer Institute, Bethesda, Maryland., Ligon KL; Broad Institute of Harvard and MIT, Cambridge, Massachusetts.; Department of Pathology, Dana-Farber Cancer Institute, Boston, Massachusetts.; Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts., Beroukhim R; Broad Institute of Harvard and MIT, Cambridge, Massachusetts.; Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.; Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, Massachusetts., Bi WL; Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Jazyk:	angličtina
Zdroj:	Neuro-oncology [Neuro Oncol] 2024 Aug 21. Date of Electronic Publication: 2024 Aug 21.
DOI:	10.1093/neuonc/noae164
Abstrakt:	Background: With the significant shift in the classification, risk stratification, and standards of care for gliomas, we sought to understand how the overall survival of patients with these tumors is impacted by molecular features, clinical metrics, and treatment received. Methods: We assembled a cohort of patients with a histopathologically diagnosed glioma from The Cancer Genome Atlas, Project Genomics Evidence Neoplasia Information Exchange, and Dana-Farber Cancer Institute/Brigham and Women's Hospital. This incorporated retrospective clinical, histological, and molecular data alongside prospective assessment of patient survival. Results: 4,400 gliomas were identified: 2,195 glioblastoma, 1,198 IDH1/2-mutant astrocytoma, 531 oligodendroglioma, 271 other IDH1/2-wildtype glioma, and 205 pediatric-type glioma. Molecular classification updated 27.2% of gliomas from their original histopathologic diagnosis. Examining the distribution of molecular alterations across glioma subtypes revealed mutually exclusive alterations within tumorigenic pathways. Non-TCGA patients had significantly improved overall survival compared to TCGA patients, with 26.7%, 55.6%, and 127.8% longer survival for glioblastoma, IDH1/2-mutant astrocytoma, and oligodendroglioma respectively (all p<0.01). Several prognostic features were characterized, including NF1 alteration and 21q loss in glioblastoma, and EGFR amplification and 22q loss in IDH1/2-mutant astrocytoma. Leveraging the size of this cohort, nomograms were generated to assess the probability of overall survival based on patient age, the molecular features of a tumor, and the treatment received. Conclusions: By applying modern molecular criteria, we characterize the genomic diversity across glioma subtypes, identify clinically applicable prognostic features, and provide a contemporary update on patient survival to serve as a reference for ongoing investigations. (© The Author(s) 2024. Published by Oxford University Press on behalf of the Society for Neuro-Oncology.)
Databáze:	MEDLINE
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