Impact of EGFRA289T/Vmutation on relapse pattern in glioblastoma.

Authors

null

Fontanilles Maxime

Cancer Centre Henri Becquerel, Rouen, France

Fontanilles Maxime , Alexandra Noeuveglise , Nasrin Vasseur , Ludivine Beaussire , Florent Marguet , Romain Modzelewski , Chantal Hanzen , Cristina Alexandru , Nicolas Magne , Olivier Langlois , Frédéric Di Fiore , Florian Clatot , Sébastien Thureau

Organizations

Cancer Centre Henri Becquerel, Rouen, France, INSERM, U1079, IRON Group, University of Normandy, Rouen, France, Institute of Research Onco-Normand (IRON), Rouen University Hospital and Centre Henri Becquerel, Rouen, France, Rouen University Hospital Charles Nicolle, Rouen, France, Centre Henri Becquerel, Rouen, France, INSERM U1245, IRON Group, Centre Henri Becquerel, University Hospital, University of Normandy, Rouen, France, Department of Medical Oncology, Centre Henri Becquerel, Rouen, France

Research Funding

Other

Background: The prediction of the relapse pattern is an important issue in glioblastoma for personalized approach. Molecular factors, such as MGMT promoter methylation, influence relapse in- or out-field of the initial radiotherapy volume. Recently, a recurrent mutation located at position 289 of the extracellular domain of the epidermal growth factor receptor (EGFRA289mut) has been associated with a more infiltrative phenotype in glioblastoma. The primary objective of the present study was to explore the impact of EGFRA289mut on the pattern of relapse after a chemo-radiotherapy based treatment of patients suffering from glioblastoma. Methods: An ancillary study from a monocentric prospective cohort of patients suffering from glioblastoma was conducted. All patients received radiotherapy and concomitant temozolomide. The population was divided into two groups according to EGFRA289 status (mutated versus wild-type). Primary endpoint was the overlap score (varying from 0 to 1) between initial irradiated tumor volume (Vinit) and relapse volume (Vr). Vinit was the initial 95% isodose of the radiotherapy and Vr was delineated using the enhanced MRI T1-weighted part of the relapse tumor. Secondary endpoints explored the impact of other EGFR extracellular mutations, EGFR amplification and EGFRvIII on the relapse pattern, as well as the impact of EGFRA289mut on survival. EGFR alterations were identified using next-generation sequencing or droplet-digital PCR based methods on formalin-fixed paraffin-embedded samples collected at initial diagnosis. Results: One hundred patients were included: 11% of the population had EGFRA289mut glioblastoma (n = 11/100). EGFRA289mut glioblastomas had a relapse pattern more marginal compared to EGFRA289wt glioblastomas: a mean overlap score Vinit/Vr of 0.78 was observed in the EGFRA289mut group versus 0.94 in the EGFRA289wtgroup (p = 0.021). The proportion of EGFRA289mutglioblastomas in the outfield relapse (overlap score < 0.8) has a trend to be higher than in the infield relapse (overlap score > 0.8): 25% (n = 2/8) versus 9.8% (n = 9/92) for the EGFRA289wt population, p = 0.21. Neither EGFR amplification nor EGFRvIII did influence overlap score Vinit/Vr. In our population, EGFRA289mut did not influence survival. Conclusions:EGFRA289mutinfluences the relapse pattern in a population of patients suffering from glioblastoma. The role of EGFRA289mut as a decision-making biomarker for personalized radiotherapy should now be investigated in dedicated clinical trial. Clinical trial information: NCT02617745.

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Abstract Details

Meeting

2022 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Central Nervous System Tumors

Track

Central Nervous System Tumors

Sub Track

Primary CNS Tumors–Glioma

Clinical Trial Registration Number

NCT02617745

Citation

J Clin Oncol 40, 2022 (suppl 16; abstr 2046)

DOI

10.1200/JCO.2022.40.16_suppl.2046

Abstract #

2046

Poster Bd #

384

Abstract Disclosures