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Prospective genomically guided identification of "early/evolving" and "undersampled" IDH-wildtype glioblastoma leads to improved clinical outcomes.
Zhang, Yalan; Lucas, Calixto-Hope G; Young, Jacob S; Morshed, Ramin A; McCoy, Lucie; Oberheim Bush, Nancy Ann; Taylor, Jennie W; Daras, Mariza; Butowski, Nicholas A; Villanueva-Meyer, Javier E; Cha, Soonmee; Wrensch, Margaret; Wiencke, John K; Lee, Julieann C; Pekmezci, Melike; Phillips, Joanna J; Perry, Arie; Bollen, Andrew W; Aghi, Manish K; Theodosopoulos, Philip; Chang, Edward F; Hervey-Jumper, Shawn L; Berger, Mitchel S; Clarke, Jennifer L; Chang, Susan M; Molinaro, Annette M; Solomon, David A.
Afiliação
  • Zhang Y; Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA.
  • Lucas CG; Department of Pathology, University of California, San Francisco, San Francisco, California, USA.
  • Young JS; Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA.
  • Morshed RA; Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA.
  • McCoy L; Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA.
  • Oberheim Bush NA; Division of Neuro-Oncology, Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA.
  • Taylor JW; Department of Neurology, University of California, San Francisco, San Francisco, California, USA.
  • Daras M; Division of Neuro-Oncology, Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA.
  • Butowski NA; Department of Neurology, University of California, San Francisco, San Francisco, California, USA.
  • Villanueva-Meyer JE; Division of Neuro-Oncology, Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA.
  • Cha S; Department of Neurology, University of California, San Francisco, San Francisco, California, USA.
  • Wrensch M; Division of Neuro-Oncology, Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA.
  • Wiencke JK; Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA.
  • Lee JC; Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA.
  • Pekmezci M; Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA.
  • Phillips JJ; Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA.
  • Perry A; Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA.
  • Bollen AW; Department of Pathology, University of California, San Francisco, San Francisco, California, USA.
  • Aghi MK; Department of Pathology, University of California, San Francisco, San Francisco, California, USA.
  • Theodosopoulos P; Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA.
  • Chang EF; Department of Pathology, University of California, San Francisco, San Francisco, California, USA.
  • Hervey-Jumper SL; Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA.
  • Berger MS; Department of Pathology, University of California, San Francisco, San Francisco, California, USA.
  • Clarke JL; Department of Pathology, University of California, San Francisco, San Francisco, California, USA.
  • Chang SM; Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA.
  • Molinaro AM; Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA.
  • Solomon DA; Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA.
Neuro Oncol ; 24(10): 1749-1762, 2022 10 03.
Article em En | MEDLINE | ID: mdl-35395677
ABSTRACT

BACKGROUND:

Genomic profiling studies of diffuse gliomas have led to new improved classification schemes that better predict patient outcomes compared to conventional histomorphology alone. One example is the recognition that patients with IDH-wildtype diffuse astrocytic gliomas demonstrating lower-grade histologic features but genomic and/or epigenomic profile characteristic of glioblastoma typically have poor outcomes similar to patients with histologically diagnosed glioblastoma. Here we sought to determine the clinical impact of prospective genomic profiling for these IDH-wildtype diffuse astrocytic gliomas lacking high-grade histologic features but with molecular profile of glioblastoma.

METHODS:

Clinical management and outcomes were analyzed for 38 consecutive adult patients with IDH-wildtype diffuse astrocytic gliomas lacking necrosis or microvascular proliferation on histologic examination that were genomically profiled on a prospective clinical basis revealing criteria for an integrated diagnosis of "diffuse astrocytic glioma, IDH-wildtype, with molecular features of glioblastoma, WHO grade IV" per cIMPACT-NOW criteria.

RESULTS:

We identified that this diagnosis consists of two divergent clinical scenarios based on integration of radiologic, histologic, and genomic features that we term "early/evolving" and "undersampled" glioblastoma, IDH-wildtype. We found that prospective genomically guided identification of early/evolving and undersampled IDH-wildtype glioblastoma resulted in more aggressive patient management and improved clinical outcomes compared to a biologically matched historical control patient cohort receiving standard-of-care therapy based on histomorphologic diagnosis alone.

CONCLUSIONS:

These results support routine use of genomic and/or epigenomic profiling to accurately classify glial neoplasms, as these assays not only improve diagnostic classification but critically lead to more appropriate patient management that can improve clinical outcomes.
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Texto completo: 1 Coleções: 01-internacional Temas: Geral / Tipos_de_cancer / Outros_tipos Base de dados: MEDLINE Assunto principal: Astrocitoma / Neoplasias Encefálicas / Glioblastoma / Glioma Tipo de estudo: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Humans Idioma: En Revista: Neuro Oncol Assunto da revista: NEOPLASIAS / NEUROLOGIA Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Estados Unidos
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Temas: Geral / Tipos_de_cancer / Outros_tipos Base de dados: MEDLINE Assunto principal: Astrocitoma / Neoplasias Encefálicas / Glioblastoma / Glioma Tipo de estudo: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Humans Idioma: En Revista: Neuro Oncol Assunto da revista: NEOPLASIAS / NEUROLOGIA Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Estados Unidos