Neuro-oncology advances最新文献

{"title":"Longitudinal drug synergy assessment using convolutional neural network image-decoding of glioblastoma single-spheroid cultures","authors":"Anna Giczewska, Krzysztof Pastuszak, Megan Houweling, U Kulsoom Abdul, Noa Faaij, Laurine Wedekind, David Noske, Thomas Wurdinger, Anna Supernat, Bart A Westerman","doi":"10.1093/noajnl/vdad134","DOIUrl":"https://doi.org/10.1093/noajnl/vdad134","url":null,"abstract":"Abstract Background In recent years, drug combinations have become increasingly popular to improve therapeutic outcomes in various diseases, including difficult to cure cancers such as the brain cancer glioblastoma. Assessing the interaction between drugs over time is critical for predicting drug combination effectiveness and minimizing the risk of therapy resistance. However, as viability readouts of drug combination experiments are commonly performed as an endpoint where cells are lysed, longitudinal drug-interaction monitoring is currently only possible through combined endpoint assays. Methods We provide a method for massive parallel monitoring of drug interactions for 16 drug combinations in three glioblastoma models over a time frame of 18 days. In our assay, viabilities of single neurospheres are to be estimated based on image information taken at different time points. Neurosphere images taken at the final day (day 18) were matched to the respective viability measured by CellTiter-Glo 3D at the same day. This allowed to use machine learning to decode image information to viability values at day 18 as well as for the earlier time points (at day 8, 11, 15). Results Our study shows that neurosphere images allow to predict cell viability from extrapolated viabilities. This enables to assess the drug interactions in a time-window of 18 days. Our results show a clear and persistent synergistic interaction for several drug combinations over time. Conclusions Our method facilitates longitudinal drug-interaction assessment, providing new insights into the temporal-dynamic effects of drug combinations in 3D neurospheres which can help to identify more effective therapies against glioblastoma.","PeriodicalId":94157,"journal":{"name":"Neuro-oncology advances","volume":"14 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135725903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wait-and-Scan management in sporadic Koos grade 4 vestibular schwannomas: A longitudinal volumetric study","authors":"Sammy M Schouten, Stefan Cornelissen, Patrick P H J Langenhuizen, Thijs T G Jansen, Jef J S Mulder, Jolanda Derks, Jeroen B Verheul, Henricus P M Kunst","doi":"10.1093/noajnl/vdad144","DOIUrl":"https://doi.org/10.1093/noajnl/vdad144","url":null,"abstract":"Abstract Background Volumetric natural history studies specifically on large vestibular schwannomas (VSs), commonly classified as Koos grade 4, are lacking. The aim of the current study is to present the volumetric tumor evolution in sporadic Koos grade 4 VSs and possible predictors for tumor growth. Methods Volumetric tumor measurements and tumor evolution patterns from serial MRI studies were analyzed from selected consecutive patients with Koos grade 4 VS undergoing initial wait-and-scan management between January 2001 and July 2020. The significant volumetric threshold was defined as a change in volume of ≥10%. Results Among 215 tumors with a median size (IQR) of 2.7cm3 (1.8-4.2), 147 tumors (68%) demonstrated growth and 75 tumors (35%) demonstrated shrinkage during follow-up. Growth-free survival rates (95% CI) at 1, 2, 5, and 10 years were 55% (48-61), 36% (29-42), 29% (23-36), and 28% (21-34), respectively and did not significantly differ in tumors >20 mm (Chi-square=.40; P-value=.53). Four tumor evolution patterns (% of total) were observed: continued growth (60); initial growth then shrinkage (7); continued shrinkage (27); and stability (5). Good hearing (adjusted HR 2.21, 95% CI 1.48-3.30; P<.001) and peritumoral edema (adjusted HR 2.22, 95% CI 1.18-4.13; P.01) at diagnosis were significantly associated with an increased likelihood of growth. Conclusions Koos grade 4 VSs show a wide variety in size and growth. Due to variable growth patterns, an initial wait-and-scan strategy with short scan intervals may be an acceptable option in selected tumors, if no significant clinical symptoms of mass effect that warrant treatment are present.","PeriodicalId":94157,"journal":{"name":"Neuro-oncology advances","volume":"4 11","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135874199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Neurogenome study: Comprehensive molecular profiling to optimize treatment for Danish glioblastoma patients","authors":"Dorte Schou Nørøxe, Simone Maarup, Vincent Fougner, Aida Muhic, Søren Møller, Thomas Urup, Maya Jeje Schuang Lü, Joachim Weischenfeldt, Adam Espe Hansen, Hans Skovgaard Poulsen, Ulrik Lassen, Benedikte Hasselbalch","doi":"10.1093/noajnl/vdad137","DOIUrl":"https://doi.org/10.1093/noajnl/vdad137","url":null,"abstract":"Abstract Background Glioblastoma is an aggressive brain cancer with no possibility for cure. Treatment and survival have only improved slightly since 2005 when the current regime was implemented. The limited improvements in the treatment of glioblastoma, may reflect our poor understanding of the disease. We hypothesize that systematically collected translational data will improve knowledge and hereby treatment. Methods We have been performing whole exome sequencing in glioblastoma tumor tissue since 2016 and whole genome sequencing since 2020 with the aim of offering experimental treatment. Results We have sequenced 400+ GBM patients and from these 100+ are paired tumor samples from relapse surgery. To develop genomic profiling and to increase the information of each patient´s contribution, we have initiated the Neurogenome study as of June 2022. The Neurogenome protocol is a national, comprehensive, translational, omic-protocol. It is a continuation of two previous protocols from 2016 and forth in our department, but with more sub studies added, focusing on the translational and clinical utility. We collect and analyze data from an out-patient clinic in a systematically approach to a number of subprojects ranging from basic science to applied clinical science, including clinical trials. Conclusion The protocol will act as backbone for future projects in the national research center, Danish Comprehensive Cancer Center - Brain Tumor Center with the overall aim to select eligible patients for experimental treatment based upon genomic alterations. The article will present the Neurogenome setup and a presentation of selected projects that are based upon inclusion.","PeriodicalId":94157,"journal":{"name":"Neuro-oncology advances","volume":"59 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135975144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Monitoring Response to a Clinically Relevant IDH Inhibitor in Glioma – Hyperpolarized 13C Magnetic Resonance Spectroscopy Approaches","authors":"Donghyun Hong, Yaewon Kim, Chandrasekhar Mushti, Noriaki Minami, Jing Wu, Murali Krishna Cherukuri, Rolf E Swenson, Daniel B Vigneron, Sabrina M Ronen","doi":"10.1093/noajnl/vdad143","DOIUrl":"https://doi.org/10.1093/noajnl/vdad143","url":null,"abstract":"Abstract Background Mutant isocitrate dehydrogenase (IDHmut) catalyzes 2-hydroxyglutarate (2HG) production and is considered a therapeutic target for IDHmut tumors. However, response is mostly associated with inhibition of tumor growth. Response assessment via anatomic imaging is therefore challenging. Our goal was to directly detect IDHmut inhibition using a new hyperpolarized (HP) 13C magnetic resonance spectroscopy (MRS)-based approach to non-invasively assess α-ketoglutarate (αKG) metabolism to 2HG and glutamate. Methods We studied IDHmut-expressing normal human astrocyte (NHAIDH1mut) cells and rats with BT257 tumors, and assessed response to the IDHmut inhibitor BAY-1436032 (n ≥ 4). We developed a new 13C Echo Planar Spectroscopic Imaging sequence with an optimized RF pulse to monitor the fate of HP [1-13C]αKG and [5-12C,1-13C]αKG with a 2.5x2.5x8 mm3 spatial resolution. Results Cell studies confirmed that BAY-1436032-treatment leads to a drop in HP 2HG and an increase in HP glutamate detectable with both HP substrates. Data using HP [5-12C,1-13C]αKG also demonstrated that its conversion to 2HG is detectable without the proximal 1.1% natural abundance [5-13C]αKG signal. In vivo studies showed that glutamate is produced in normal brains but no 2HG is detectable. In tumor-bearing rats, we detected the production of both 2HG and glutamate, and BAY-1436032-treatment led to a drop in 2HG and an increase in glutamate. Using HP [5-12C,1-13C]αKG we detected metabolism with an SNR of 23 for 2HG and 17 for glutamate. Conclusion Our findings point to the clinical potential of HP αKG, which recently received FDA IND approval for research, for non-invasive localized imaging of IDHmut status.","PeriodicalId":94157,"journal":{"name":"Neuro-oncology advances","volume":"61 5","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135975316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spatial architecture of high-grade glioma reveals tumor heterogeneity within distinct domains","authors":"Joel J D Moffet, Oluwaseun E Fatunla, Lutz Freytag, Jurgen Kriel, Jordan J Jones, Samuel J Roberts-Thomson, Anna Pavenko, David K Scoville, Liang Zhang, Yan Liang, Andrew P Morokoff, James R Whittle, Saskia Freytag, Sarah A Best","doi":"10.1093/noajnl/vdad142","DOIUrl":"https://doi.org/10.1093/noajnl/vdad142","url":null,"abstract":"Abstract Background High-grade gliomas (HGG) are aggressive primary brain cancers with poor response to standard regimens, driven by immense heterogeneity. In isocitrate dehydrogenase (IDH) wild-type high-grade glioma (glioblastoma, GBM), increased intra-tumoral heterogeneity is associated with more aggressive disease. Methods Spatial technologies can dissect complex heterogeneity within the tumor ecosystem by preserving cellular organization in situ. We employed GeoMx® digital spatial profiling, CosMx® spatial molecular imaging, Xenium® in situ mapping and Visium® spatial gene expression in experimental and validation patient cohorts to interrogate the transcriptional landscape in HGG. Results Here, we construct a high-resolution molecular map of heterogeneity in GBM and IDH-mutant patient samples to investigate the cellular communities that compose high-grade glioma. We uncovered striking diversity in the tumor landscape and degree of spatial heterogeneity within the cellular composition of the tumors. The immune distribution was diverse between samples, however consistently correlated spatially with distinct tumor cell phenotypes, validated across tumor cohorts. Reconstructing the tumor architecture revealed two distinct niches, one composed of tumor cells that most closely resemble normal glial cells, associated with microglia; and the other niche populated by monocytes and mesenchymal tumor cells. Conclusions This primary study reveals high levels of intra-tumoral heterogeneity in high-grade gliomas, associated with a diverse immune landscape within spatially localized regions.","PeriodicalId":94157,"journal":{"name":"Neuro-oncology advances","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135455895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Direct Image to Subtype Prediction for Brain Tumors using Deep Learning","authors":"Katherine J Hewitt, Chiara M L Löffler, Hannah Sophie Muti, Anna Sophie Berghoff, Christian Eisenlöffel, Marko van Treeck, Zunamys I Carrero, Omar S M El Nahhas, Gregory P Veldhuizen, Sophie Weil, Oliver L Saldanha, Laura Bejan, Thomas O Millner, Sebastian Brandner, Sascha Brückmann, Jakob Nikolas Kather","doi":"10.1093/noajnl/vdad139","DOIUrl":"https://doi.org/10.1093/noajnl/vdad139","url":null,"abstract":"Abstract Background Deep Learning (DL) can predict molecular alterations of solid tumors directly from routine histopathology slides. Since the 2021 update of the World Health Organization (WHO) diagnostic criteria, the classification of brain tumors integrates both histopathological and molecular information. We hypothesize that DL can predict molecular alterations as well as WHO subtyping of brain tumors from hematoxylin and eosin-stained histopathology slides. Methods We used weakly supervised DL and applied it to three large cohorts of brain tumor samples, comprising N=2,845 patients. Results We found that the key molecular alterations for subtyping, IDH and ATRX, as well as 1p19q co-deletion, were predictable from histology with an area under the receiver operating characteristic curve (AUROC) of 0.95, 0.90 and 0.80 in the training cohort respectively. These findings were upheld in external validation cohorts with AUROCs of 0.90, 0.79 and 0.87 for prediction of IDH, ATRX and 1p19q co-deletion respectively. Conclusions In the future, such DL-based implementations could ease diagnostic workflows, particularly for situations in which advanced molecular testing is not readily available.","PeriodicalId":94157,"journal":{"name":"Neuro-oncology advances","volume":"39 10","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135455136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GLIOMA-08 INTRACRANIAL HIGH-GRADE GLIOMA MANAGEMENT IN COTE D’IVOIRE : ABOUT 19 COALIGATED CASES FROM MARCH 2019 TO JUNE 2021","authors":"Landry Drogba, Raïssa Diaby, Grace Djondé, Landry Konan, Jean-Marcel Okamon, Wilfried Meuga, Dominique N'Dri","doi":"10.1093/noajnl/vdad121.007","DOIUrl":"https://doi.org/10.1093/noajnl/vdad121.007","url":null,"abstract":"Abstract INTRODUCTION Intracranial malignant gliomas are serious conditions that constitute a therapeutic challenge. In Côte d'Ivoire, since 2019, their care meets international standards with the advent of the National Center of Radiotherapy and Medical Oncology Alassane Ouattara and interdisciplinary consultation meetings. Our objective was to evaluate the morbidity and mortality of patients treated for high-grade gliomas in Côte d'Ivoire. MATERIALS AND METHODS We realized from March 2019 to June 2021, a retrospective cohort study on 19 patients with malignant intracranial glioma, without distinction of age and sex, whether alive or deceased. They were 12 male patients and 07 female patients. The parameters studied were, among others, the type and quality of complementary treatment, the evolution under treatment, and the time to onset of recurrence and death. RESULTS The time to consultation was early in 57.9% of cases. High ICP syndrome was the main reason for consultation at 51.6%, followed by neurological deficit. Surgery was performed on average in all patients within 30 days after imaging. The histological diagnosis of grade 4 glioma was pronounced in 16 patients. Postoperative radiotherapy was performed in 94.7% of cases, associated with concomitant then adjuvant chemotherapy with temozolomide in 84.2% of patients. During the treatment, two cases of local recurrence were notified. At the end of the cohort, the death rate was estimated at 73.7%, with a median survival of 11 months and extremes ranging from 06 months to 34 months. CONCLUSION Despite the availability and application of reference therapeutic processes, malignant glioma remains, due to many factors related to our context, a very pejorative prognosis. This study should continue with the inclusion of a larger number of patients in order to review the state of play of the management of high-grade gliomas in Côte d'Ivoire.","PeriodicalId":94157,"journal":{"name":"Neuro-oncology advances","volume":"61 17","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135813239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"OTHER-09 RATES AND PATTERNS OF CENTRAL DIABETES INSIPIDUS AFTER SURGERY FOR SELLAR AND PARASELLAR TUMORS AT THE KENYATTA NATIONAL HOSPITAL","authors":"Gilbert Ngetich, Peter Kitunguu, Michael Magoha, Susan Karanja","doi":"10.1093/noajnl/vdad121.030","DOIUrl":"https://doi.org/10.1093/noajnl/vdad121.030","url":null,"abstract":"Abstract BACKGROUND Central Diabetes Insipidus (DI) is a common post operative complication after procedures for sellar and parasellar tumors. It is associated with increased morbidity, mortality and prolonged hospital stay. It is diagnosed clinically by symptoms of polyuria and polydipsia and measuring serum sodium and osmolality as well as urine osmolality and specific gravity (SG). There is limited data on rates and patterns of post operative central DI for tumors in this anatomically complex region even with increasing number surgeries being done for these tumors. OBJECTIVE To determine the rates and patterns of post-operative central Diabetes Insipidus in patients with sellar and parasellar tumors at the (Kenyatta National Hospital) KNH. STUDY DESIGN This was a descriptive cross-sectional study. Study Setting: The study was conducted at KNH Neurosurgery units and critical care units. Methodology: This study involved 24 participants following surgery for sellar and parasellar tumors. Informed consent was obtained from the participants. Clinical assessment for presence polyuria and polydipsia and laboratory measurement of serum sodium and urine SG for features for central DI was done. DATA RESULTS The mean age of the patients was 28.69 years, 70.8% were female and 29.2% were male. The most common tumor as confirmed by histology was craniopharyngioma seen in 33.3% of the patients. With regards to age craniopharyngioma, pilocytic astrocytoma and arachnoid cyst was seen in paediatric age group predominantly while meningioma and pituitary adenoma was more common in adults. Polyuria and polydipsia were the main clinical features seen post operatively in patients with Central DI. 69.2% presented with both polyuria and polydipsia, 30.8% presented with polyuria alone without polydipsia. The rate of post operative Central DI after surgery for sellar and parasellar tumors was 54.2%. The most common pattern was transient type occurring in 76.9% of the cases. Biphasic pattern was seen in 23.1%.","PeriodicalId":94157,"journal":{"name":"Neuro-oncology advances","volume":"25 34","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135813353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GLIOMA-02 HISTOPATHOLOGIC AND MOLECULAR PROFILE OF GLIOMAS: A 9-YEAR RETROSPECTIVE STUDY OF CASES DIAGNOSED IN LAGOS NIGERIA","authors":"Lateef Odukoya, Thomas Kollmeyer, Jeanette Eckel-Passow, Cristiane Ida, Daniel Lachance, Ekokobe Fonkem, Kabir Badmos, Olufemi Bankole, Gaspar Kitange, Adetola Daramola, Charles Anunobi, Robert Jenkins","doi":"10.1093/noajnl/vdad121.002","DOIUrl":"https://doi.org/10.1093/noajnl/vdad121.002","url":null,"abstract":"Abstract BACKGROUND The diagnosis and management of patients with brain tumors currently uses WHO defined morphologic and molecular features. However, neuro-oncology practice in low resource settings relies solely on histomorphology. This study aims to reclassify glioma cases diagnosed in the Department of Anatomic and Molecular Pathology Lagos University Teaching Hospital using the WHO 2021 classification. METHODS Fifty-six cases of glioma diagnosed between 2013 to 2021 were evaluated. Morphologic diagnosis was reassessed. Five-micron sections were obtained for immunohistochemistry (IHC), and genetic testing (DNA and RNA) after manual macrodissection for tumor enrichment used 10-µm sections. IHC for IDH1-R132H, ATRX, BRAF-V600E, p53, Ki67 and H3-K27M and Oncoscan chromosomal microarray analysis were performed. NGS mutation/fusion analysis and EPIC methylation array profiling are in progress. RESULTS Of the 56 cases evaluated, median age was 22 years (range, 1-60); 71% were male. The initial morphologic diagnoses included 21 pilocytic astrocytoma, 11 glioblastoma, 9 ependymoma, 7 diffuse astrocytoma, 3 anaplastic astrocytoma, 2 high-grade gliomas, 1 oligodendroglioma, 1 diffuse midline glioma, and 1 pleomorphic xanthoastrocytoma (PXA). Histomorphologic re-evaluation revealed discordant diagnosis in 29% (16/56) of cases. Of the 56 cases, 73% (41/56) had usable DNA yield and 38% (21/56) had DNA yield of ≥750ng. Chromosomal microarray analysis was completed for 50% (28/56) cases. The revised WHO 2021 diagnosis was: 5 glioblastoma IDH-wildtype, 5 pilocytic astrocytoma, 4 glioma NEC, 3 posterior fossa ependymoma, group B, 3 PXA, 3 astrocytoma IDH-mutant, 2 pediatric low-grade gliomas, 2 supratentorial ependymoma, ZFTA fusion-positive, 1 posterior fossa ependymoma, group A. In 71% (20/28) of cases with molecular testing, diagnosis was revised using WHO 2021 criteria. CONCLUSION Most cases had usable DNA. Overall, histologic re-evaluation and molecular based on the WHO 2021 criteria refined the diagnosis in 48% (27/56) of cases.","PeriodicalId":94157,"journal":{"name":"Neuro-oncology advances","volume":"22 9","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135813497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GLIOMA-15 RETROSPECTIVE REVIEW OF GLIOBLASTOMA MULTIFORME CASES MANAGED AT A TERTIARY LEVEL HOSPITAL IN KENYA","authors":"Karishma Sharma, Manel Haj Mansour","doi":"10.1093/noajnl/vdad121.012","DOIUrl":"https://doi.org/10.1093/noajnl/vdad121.012","url":null,"abstract":"Abstract Glioblastoma Multiforme(GBM) is one of the most aggressive tumors of the central nervous system. Though rare, it accounts for the commonest primary brain tumor in adults. Despite recent advances in the treatment of patients with GBM, it portends a poor prognosis. There is limited published data of GBM from sub-Saharan Africa(SSA). We performed a retrospective chart review of 24 patients seen in the Medical Oncology service at the Aga Khan University Hospital between January 2018 and December 2020. Clinical, radiological, pathological outcomes were investigated, analyzed and compared with data from the literature. A total of twenty-four patients were seen at the medical oncology clinic over the 3-year period. The median age of the patients was 54 years (IQR 44.7-65) and majority of patients (>80%) were of African descent. Of the 24 patients, 13(54.2%) were male and 11(45.8%) were female. Headaches were the commonest clinical presentation and frontal lobe was commonest tumor location on imaging. The median size of the tumor was 4.5cm (IQR 3.8-6.45). Following diagnosis, eighteen(75%) patients underwent maximal safe resection of the tumor with presence of residual tumor in thirteen (56%) of the post-operative scans. Nineteen patients(83%) were initiated on concurrent chemotherapy (Temozolamide) and Radiation therapy (CCRT) as part of adjuvant treatment. Of those initiated on adjuvant Temozolamide following CCRT, more than one-third completed one year of treatment. At 6 months following diagnosis, 25% of patients remained stable while 25% had disease progression. Our study adds to the literature which demonstrates that patients seen in SSA with GBM present at younger age, with bigger tumor size but tend to do better compared to those in the west. Understanding of the molecular alterations within the tumor and larger prospective studies are needed to define the behavior of GBM in SSA.","PeriodicalId":94157,"journal":{"name":"Neuro-oncology advances","volume":"13 33","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135814217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}