Daniele Armocida1,2, Alessandro Pesce3,4, Alessandro Frati3,4, Antonio Santoro3, Maurizio Salvati4. 1. Human Neurosciences Department Neurosurgery Division "Sapienza" University, Rome, Italy. danielearmocida@yahoo.it. 2. AOU "Policlinico Umberto I", Viale del Policlinico 155, 00161, Rome, Italy. danielearmocida@yahoo.it. 3. Human Neurosciences Department Neurosurgery Division "Sapienza" University, Rome, Italy. 4. IRCCS "Neuromed", Pozzilli, IS, Italy.
Abstract
BACKGROUND: In 2019 a group of University of Pennsylvania (Hoffman et al., J Neurooncol 145: 321-328, 2019) aimed to explore the prognostic impact of expression of epidermal growth factor receptor (EGFR), one of the most common genetic alterations in WT-GBM, in young adults with IDH-WT GBM, suggesting an inferior outcomes in young adults (< 45yo) with newly diagnosed, IDH-WT GBM. At the same time, our group were considering the dimension of this subpopulation treated in our centre, and we performed the same analysis, comparing datas with affected elderly adults. METHODS: We explore the prognostic impact of EGFR expression status in young adults with IDH-WT GBM, and compare this impact with the affected elderly adults. We therefore analyzed clinical characteristics, tumor genetics, and clinical outcomes in a cohort of adults aged 18-45 years with newly diagnosed WT GBM. We selected a total of 146 patients affected by newly diagnosed IDH-WT GBM who underwent surgery, radiation, and chemotherapy in our Institution in the period ranging between January 2014 and December 2016. We focused primarily on the prognostic impact of EGFR expression. RESULTS: We confirmed through a Bivariate Analysis that the Age of the Patients, the Volume of the lesions, were statistically strongly associated with the survival parameters; The general OS of the cohort presented a breakthrough point between the patients who were respectively younger and older than 45 years, EGFR mutation was per se not associated to a survival reduction in all the cohort patients. When analyzing exclusively the Survival parameters of the patients whose age was under 40, it was possible to outline a non statistically significant trend towards a lesser OS in younger patients harboring an EGFR expression. CONCLUSIONS: Once again the main difference in terms of OS in GBM is shown in a EOR and in Age. To our knowledge, ours is the second study (Hoffman et al., J Neurooncol 145: 321-328, 2019) to evaluate the prognostic impact of EGFR CN gain specifically in young adults with IDH-WT GBM and in the era of modern radiation and Temozolomide, but is the first one to compares this impact with a population of adults over 45, and correlates this date with clinical onset, dimension and localization of disease between this groups. We suggest other centers to evaluate this important finding with a larger number of patients and we are inclined to accept collaborations to increase the power of this study.
BACKGROUND: In 2019 a group of University of Pennsylvania (Hoffman et al., J Neurooncol 145: 321-328, 2019) aimed to explore the prognostic impact of expression of epidermal growth factor receptor (EGFR), one of the most common genetic alterations in WT-GBM, in young adults with IDH-WT GBM, suggesting an inferior outcomes in young adults (< 45yo) with newly diagnosed, IDH-WT GBM. At the same time, our group were considering the dimension of this subpopulation treated in our centre, and we performed the same analysis, comparing datas with affected elderly adults. METHODS: We explore the prognostic impact of EGFR expression status in young adults with IDH-WT GBM, and compare this impact with the affected elderly adults. We therefore analyzed clinical characteristics, tumor genetics, and clinical outcomes in a cohort of adults aged 18-45 years with newly diagnosed WT GBM. We selected a total of 146 patients affected by newly diagnosed IDH-WT GBM who underwent surgery, radiation, and chemotherapy in our Institution in the period ranging between January 2014 and December 2016. We focused primarily on the prognostic impact of EGFR expression. RESULTS: We confirmed through a Bivariate Analysis that the Age of the Patients, the Volume of the lesions, were statistically strongly associated with the survival parameters; The general OS of the cohort presented a breakthrough point between the patients who were respectively younger and older than 45 years, EGFR mutation was per se not associated to a survival reduction in all the cohort patients. When analyzing exclusively the Survival parameters of the patients whose age was under 40, it was possible to outline a non statistically significant trend towards a lesser OS in younger patients harboring an EGFR expression. CONCLUSIONS: Once again the main difference in terms of OS in GBM is shown in a EOR and in Age. To our knowledge, ours is the second study (Hoffman et al., J Neurooncol 145: 321-328, 2019) to evaluate the prognostic impact of EGFR CN gain specifically in young adults with IDH-WT GBM and in the era of modern radiation and Temozolomide, but is the first one to compares this impact with a population of adults over 45, and correlates this date with clinical onset, dimension and localization of disease between this groups. We suggest other centers to evaluate this important finding with a larger number of patients and we are inclined to accept collaborations to increase the power of this study.
Entities:
Keywords:
EGFR; Glioblastoma; IDH; Ki67; Long term survival; Prognostic factor; p53
Authors: Beth K Neilsen; Richard Sleightholm; Rodney McComb; Shakti H Ramkissoon; Jeffrey S Ross; Robert J Corona; Vincent A Miller; Matthew Cooke; Michele R Aizenberg Journal: J Neurooncol Date: 2018-12-09 Impact factor: 4.130
Authors: Erwin G Van Meir; Costas G Hadjipanayis; Andrew D Norden; Hui-Kuo Shu; Patrick Y Wen; Jeffrey J Olson Journal: CA Cancer J Clin Date: 2010 May-Jun Impact factor: 508.702
Authors: Daniel I Hoffman; Kalil G Abdullah; Makayla McCoskey; Zev A Binder; Donald M O'Rourke; Arati S Desai; MacLean P Nasrallah; Ashkan Bigdeli; Jennifer J D Morrissette; Steven Brem; Stephen J Bagley Journal: J Neurooncol Date: 2019-09-21 Impact factor: 4.130
Authors: Michele Ceccarelli; Floris P Barthel; Tathiane M Malta; Thais S Sabedot; Sofie R Salama; Bradley A Murray; Olena Morozova; Yulia Newton; Amie Radenbaugh; Stefano M Pagnotta; Samreen Anjum; Jiguang Wang; Ganiraju Manyam; Pietro Zoppoli; Shiyun Ling; Arjun A Rao; Mia Grifford; Andrew D Cherniack; Hailei Zhang; Laila Poisson; Carlos Gilberto Carlotti; Daniela Pretti da Cunha Tirapelli; Arvind Rao; Tom Mikkelsen; Ching C Lau; W K Alfred Yung; Raul Rabadan; Jason Huse; Daniel J Brat; Norman L Lehman; Jill S Barnholtz-Sloan; Siyuan Zheng; Kenneth Hess; Ganesh Rao; Matthew Meyerson; Rameen Beroukhim; Lee Cooper; Rehan Akbani; Margaret Wrensch; David Haussler; Kenneth D Aldape; Peter W Laird; David H Gutmann; Houtan Noushmehr; Antonio Iavarone; Roel G W Verhaak Journal: Cell Date: 2016-01-28 Impact factor: 41.582
Authors: Kristen M Turner; Viraj Deshpande; Doruk Beyter; Tomoyuki Koga; Jessica Rusert; Catherine Lee; Bin Li; Karen Arden; Bing Ren; David A Nathanson; Harley I Kornblum; Michael D Taylor; Sharmeela Kaushal; Webster K Cavenee; Robert Wechsler-Reya; Frank B Furnari; Scott R Vandenberg; P Nagesh Rao; Geoffrey M Wahl; Vineet Bafna; Paul S Mischel Journal: Nature Date: 2017-02-08 Impact factor: 49.962
Authors: Sherise D Ferguson; Joanne Xiu; Shiao-Pei Weathers; Shouhao Zhou; Santosh Kesari; Stephanie E Weiss; Roeland G Verhaak; Raymond J Hohl; Geoffrey R Barger; Sandeep K Reddy; Amy B Heimberger Journal: Oncotarget Date: 2016-10-25