Impact of upfront adjuvant chemoradiation on survival in patients with molecularly defined oligodendroglioma: the benefits of PCV over TMZ.

IF 3.2 2区医学 Q2 CLINICAL NEUROLOGY

Journal of Neuro-Oncology Pub Date : 2024-10-09 DOI:10.1007/s11060-024-04829-6

Jordina Rincon-Torroella, Maureen Rakovec, Anita L Kalluri, Kelly Jiang, Carly Weber-Levine, Megan Parker, Divyaansh Raj, Josh Materi, Sadra Sepehri, Abel Ferres, Karisa C Schreck, Iban Aldecoa, Calixto-Hope G Lucas, Haris I Sair, Kristin J Redmond, Matthias Holdhoff, Jon Weingart, Henry Brem, Josep J González Sánchez, Xiaobu Ye, Chetan Bettegowda

{"title":"Impact of upfront adjuvant chemoradiation on survival in patients with molecularly defined oligodendroglioma: the benefits of PCV over TMZ.","authors":"Jordina Rincon-Torroella, Maureen Rakovec, Anita L Kalluri, Kelly Jiang, Carly Weber-Levine, Megan Parker, Divyaansh Raj, Josh Materi, Sadra Sepehri, Abel Ferres, Karisa C Schreck, Iban Aldecoa, Calixto-Hope G Lucas, Haris I Sair, Kristin J Redmond, Matthias Holdhoff, Jon Weingart, Henry Brem, Josep J González Sánchez, Xiaobu Ye, Chetan Bettegowda","doi":"10.1007/s11060-024-04829-6","DOIUrl":null,"url":null,"abstract":"Purpose: Oligodendroglioma is an adult-type diffuse glioma defined by 1p/19q codeletion and IDH1/2 mutation. Treatment includes surgery followed by observation alone in select low-grade tumors, or combination radiation and chemotherapy with procarbazine, lomustine, and vincristine (PCV) or temozolomide (TMZ). While prospective studies investigating treatments for molecularly defined oligodendrogliomas are ongoing, this retrospective study analyzes the relationship between adjuvant regimens and progression-free survival (PFS).Methods: Adults with IDH-mutant, 1p/19q codeleted oligodendroglioma (WHO grade 2 or 3) who underwent surgery between 2005 and 2021 were identified. Clinical data, disease characteristics, treatment, and outcomes were collected.Results: A total of 207 patients with grade 2 and 70 with grade 3 oligodendrogliomas were identified. Median (IQR) follow-up was 57 (87) months. Patients with grade 3 tumors who received adjuvant radiation and PCV had longer median PFS (> 110 months) than patients who received radiation and TMZ (52 months, p = 0.008) or no adjuvant chemoradiation (83 months, p = 0.03), which was not seen in grade 2 tumors (p = 0.8). In multivariate analysis, patients who received PCV chemotherapy (Relative Risk [95% CI] = 0.24[0.05-1.08] and radiotherapy (0.46[0.21-1.02]) trended towards longer PFS, independently of grade.Conclusion: Adjuvant radiation and PCV are associated with improved PFS over radiation with TMZ in patients with grade 3 molecularly defined oligodendrogliomas, and all-grade patients treated with PCV trended towards decreased risk of recurrence and progression. These results highlight the importance of ongoing clinical trials investigating these treatments.","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2000,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Neuro-Oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s11060-024-04829-6","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose: Oligodendroglioma is an adult-type diffuse glioma defined by 1p/19q codeletion and IDH1/2 mutation. Treatment includes surgery followed by observation alone in select low-grade tumors, or combination radiation and chemotherapy with procarbazine, lomustine, and vincristine (PCV) or temozolomide (TMZ). While prospective studies investigating treatments for molecularly defined oligodendrogliomas are ongoing, this retrospective study analyzes the relationship between adjuvant regimens and progression-free survival (PFS).

Methods: Adults with IDH-mutant, 1p/19q codeleted oligodendroglioma (WHO grade 2 or 3) who underwent surgery between 2005 and 2021 were identified. Clinical data, disease characteristics, treatment, and outcomes were collected.

Results: A total of 207 patients with grade 2 and 70 with grade 3 oligodendrogliomas were identified. Median (IQR) follow-up was 57 (87) months. Patients with grade 3 tumors who received adjuvant radiation and PCV had longer median PFS (> 110 months) than patients who received radiation and TMZ (52 months, p = 0.008) or no adjuvant chemoradiation (83 months, p = 0.03), which was not seen in grade 2 tumors (p = 0.8). In multivariate analysis, patients who received PCV chemotherapy (Relative Risk [95% CI] = 0.24[0.05-1.08] and radiotherapy (0.46[0.21-1.02]) trended towards longer PFS, independently of grade.

Conclusion: Adjuvant radiation and PCV are associated with improved PFS over radiation with TMZ in patients with grade 3 molecularly defined oligodendrogliomas, and all-grade patients treated with PCV trended towards decreased risk of recurrence and progression. These results highlight the importance of ongoing clinical trials investigating these treatments.

查看原文本刊更多论文

前期辅助化疗对分子定义少突胶质细胞瘤患者生存期的影响：PCV比TMZ更有优势。

目的：少突胶质细胞瘤是一种成人型弥漫性胶质瘤，定义为1p/19q编码缺失和IDH1/2突变。治疗方法包括对部分低级别肿瘤进行手术，然后进行单纯观察，或联合放疗和丙卡巴嗪、洛莫司汀和长春新碱（PCV）或替莫唑胺（TMZ）化疗。尽管针对分子定义的少突胶质瘤治疗方法的前瞻性研究正在进行中，但这项回顾性研究分析了辅助治疗方案与无进展生存期（PFS）之间的关系：方法：对2005年至2021年期间接受手术治疗的IDH突变、1p/19q编码缺失的少突胶质细胞瘤（WHO 2级或3级）成人患者进行鉴定。收集了临床数据、疾病特征、治疗方法和结果：结果：共发现207例2级和70例3级少突胶质细胞瘤患者。随访中位数（IQR）为57（87）个月。与接受放射治疗和TMZ（52个月，P = 0.008）或未接受辅助化疗（83个月，P = 0.03）的患者相比，接受放射治疗和PCV辅助治疗的3级肿瘤患者的中位PFS（大于110个月）更长，而2级肿瘤患者的中位PFS则不长（P = 0.8）。在多变量分析中，接受PCV化疗（相对风险[95% CI] = 0.24[0.05-1.08]）和放疗（0.46[0.21-1.02]）的患者有延长PFS的趋势，与分级无关：结论：对于分子定义为3级的少突胶质细胞瘤患者，与TMZ放疗相比，辅助放疗和PCV可改善患者的PFS，而接受PCV治疗的所有级别患者的复发和进展风险均呈下降趋势。这些结果凸显了正在进行的研究这些治疗方法的临床试验的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Neuro-Oncology 医学-临床神经学

CiteScore

6.60

自引率

7.70%

发文量

277

审稿时长

3.3 months

期刊介绍： The Journal of Neuro-Oncology is a multi-disciplinary journal encompassing basic, applied, and clinical investigations in all research areas as they relate to cancer and the central nervous system. It provides a single forum for communication among neurologists, neurosurgeons, radiotherapists, medical oncologists, neuropathologists, neurodiagnosticians, and laboratory-based oncologists conducting relevant research. The Journal of Neuro-Oncology does not seek to isolate the field, but rather to focus the efforts of many disciplines in one publication through a format which pulls together these diverse interests. More than any other field of oncology, cancer of the central nervous system requires multi-disciplinary approaches. To alleviate having to scan dozens of journals of cell biology, pathology, laboratory and clinical endeavours, JNO is a periodical in which current, high-quality, relevant research in all aspects of neuro-oncology may be found.