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65th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

11 - 14 May 2014, Dresden

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The prognostic impact of IDH1 R132H mutation in malignant glioma treated by combined radiochemotherapy

Meeting Abstract

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  • Antonia Horowski - Klinik für Neurochirurgie, Universitätsmedizin Göttingen
  • Timo Behm - Klinik für Neurochirurgie, Universitätsmedizin Göttingen
  • Christine Stadelmann-Nessler - Institut für Neuropathologie, Universitätsmedizin Göttingen
  • Alonso Barrentes - Institut für Neuropathologie, Universitätsmedizin Göttingen
  • Felix Behling - Institut für Neuropathologie, Universitätsmedizin Göttingen
  • Veit Rohde - Klinik für Neurochirurgie, Universitätsmedizin Göttingen
  • Christian Hartmann - Institut für Neuropathologie, Medizinische Hochschule Hannover
  • Florian Stockhammer - Klinik für Neurochirurgie, Universitätsmedizin Göttingen

Deutsche Gesellschaft für Neurochirurgie. 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Dresden, 11.-14.05.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. DocMI.03.05

doi: 10.3205/14dgnc284, urn:nbn:de:0183-14dgnc2844

Published: May 13, 2014

© 2014 Horowski et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objective: In astrocytic malignant glioma, a mutation of isocitrate dehydrogenase (IDH) 1 R132H has been reported to have more impact on survival than the histological diagnosis. However, anaplastic gliomas in that latter study had either radiotherapy or chemotherapy, but no combined treatment like the glioblastomas they were compared to. Since 2005 anaplastic astrocytomas haven been treated likewise glioblastomas in our institution. We set up a retrospective analysis investigating the role of IDH1 R132H mutation in anaplastic astrocytomas and glioblastomas treated equally from the beginning.

Method: All patients with anaplastic astrocytoma or glioblastoma, who received combined radiochemotherapy as first-line treatment and immunohistochemical staining for IDH1 R132H antibody were included. Survival data were obtained.

Results: 190 patients were eligible for this analysis. 142 patients (75%) died. Histology revealed 30 anaplastic astrocytomas and 160 glioblastomas. An IDH1 R132H mutation was present in 19 patients, of which 12 harbored anaplastic astrocytomas and 7 glioblastomas, respectively. Median survival in glioblastoma patients was 14.1 and in anaplastic astrocytomas 52.0 months (p<.0001, log rank). Median survival in glioblastoma with IDH1 R132H mutation tended to be unfavorable when compared to anaplastic astrocytomas with IDH wildtype (15.0 vs. 38.1 months, p=.0548, Gehan-Breslow-Wilcoxon Test).

Conclusions: Histology has a superior impact on survival compared to IDH1 R132H mutation, when patients received first-line radiochemotherapy. These results indicate that patients with IDH1 wildtype anaplastic astrocytoma might profit from combined treatment.