Survival outcomes in glioma patients with noncanonical IDH mutations: Beyond diagnostic improvements.

Authors

null

Enrico Franceschi

Department of Medical Oncology, Bellaria Hospital, Azienda USL - IRCCS Institute of Neurological Sciences, Bologna, Italy

Enrico Franceschi , Dario De Biase , Annalisa Pession , Alicia Tosoni , Alexandro Paccapelo , Michela Visani , Giovanni Tallini , Chiara Maria Argento , Benedetta Urbini , Stefania Bartolini , Alba Ariela Brandes

Organizations

Department of Medical Oncology, Bellaria Hospital, Azienda USL - IRCCS Institute of Neurological Sciences, Bologna, Italy, Department of Pharmacy and Biotechnology (Dipartimento di Farmacia e Biotecnologie) - Molecular Diagnostic Unit, Azienda USL di Bologna, University of Bologna, Bologna, Italy, Bellaria Maggiore Hospital, Bologna, Italy, Department of Pathology Bellaria Hospital, Bologna, Italy, Department of Medicine (Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale) - Molecular Diagnostic Unit, Azienda USL di Bologna, University of Bologna, School of Medicine, Bologna, Italy, Department of Medical Oncology, Bellaria-Maggiore Hospitals, Azienda USL di Bologna, Bologna, Italy, Clinical Oncology Unit, St Anna University Hospital, Ferrara, Italy, Department of Medical Oncology, Azienda USL– IRCCS Institute of Neurological Science, Bologna, Italy, Medical Oncology, Bellaria Hospital, Bologna, Italy

Research Funding

Other

Background: According to the 2016 WHO classification of Central Nervous System tumors, the assessment of exon 4 mutations in IDH1 or IDH2 genes is an essential step in the characterization of gliomas. The R132H mutation is the most frequent alteration in IDH1 gene, however other non-canonical IDH mutations have been identified. The aim of this study was to evaluate the prognostic role of IDH non-canonical mutations. Methods: We analyzed our institutional data warehouse for all consecutive patients (pts) with newly diagnosed, histologically proven grade II – IV IDH mutant gliomas. IDH sequencing was performed using the 454 GS-Junior next generation sequencer (NGS) (Roche Diagnostic, Mannheim, Germany). All analyses were performed on DNA from formalin fixed and paraffin embedded (FFPE) specimens. Results: The analysis included 493 pts with IDH mutations. We found 279 (56.6%) grade 2, 173 grade 3 (35.1%) gliomas, and 41 (8.3%) IDH mutant glioblastoma. Canonical IDH1 R132H mutation was found in 428 pts (86.8%). The remaining pts showed IDH2 (3.9%) or IDH 1 non-canonical mutations (mainly R132C, R132G, R132S – 9.3%). Median follow-up time was 80.5 months. Pts with non-canonical mutations showed a younger median age (32 vs 39 years, p < 0.001). Other clinical characteristics and treatments were similar across IDH groups. Median survival was 145 months (95%CI: 137.7 - 152.9) and 198.6 (95%CI 155.2– 242.1) in patients with IDH R132H and non-canonical mutations, respectively (p = 0.013). In multivariate analysis grading (p < 0.001), extent of surgery (p < 0.001), 1p19q codeletion (p = 0.003) and presence of non-canonical mutations (p = 0.022) showed a significant role for improved survival. Conclusions: Detecting non-canonical IDH1 mutations is essential for diagnosis and for prognosis in patients with gliomas. Differential enzymatic activity of non-canonical IDH1 mutations, resulting in different levels 2-hydroxyglutaratecould be the reason of improved survival.

Disclaimer

This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org

Abstract Details

Meeting

2019 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Central Nervous System Tumors

Track

Central Nervous System Tumors

Sub Track

Central Nervous System Tumors

Citation

J Clin Oncol 37, 2019 (suppl; abstr 2028)

DOI

10.1200/JCO.2019.37.15_suppl.2028

Abstract #

2028

Poster Bd #

217

Abstract Disclosures

Similar Abstracts

First Author: Keng Lam

First Author: Houjun Zhou

First Author: Hongjun Yang

First Author: Kristina Fanucci