P03.10 Analyzing the role of reoperation in high grade gliomas: a retrospective study

Abstract BACKGROUND Primary treatment of high grade glioma consists in a standard therapeutic regimen that involves maximal surgical safe resection followed by chemoradiotherapy. Unfortunately, due to its aggressive behavior, relapse is the rule in all patients. When this situation arises, treatment strategy is less clear and reintervention in selected cases is controversial and still a reason for debate. MATERIAL AND METHODS We retrospectively analysed (n=393) patients affected with high grade glioma in our institution during a period of 14 years (from January 2005 to March 2019). Treatment modality at diagnosis and recurrence, overall and progression-free survival were reviewed. RESULTS There were 320 grade IV and 73 grade III gliomas. Regarding to the modality of treatment, more procedures with radical intention (n=227) than biopsies (n=166) were performed. At progression, glioblastoma patients were treated in (n=118) cases. We decided to reoperate (n=30) cases who also received second-line chemotherapies.The other group (n=88) received only systemic treatment. Median overall survival assessed from initial diagnosis was 23 months(95% CI 17–28.9) versus 17 months (95% CI 15.7–18.2) in patients with surgery at recurrence comparing to those who did not undergo second surgery, (p< 0.05). In addition, clinical condition of most patients did not worsen after the second surgery. CONCLUSION Second surgery for recurrent glioblastoma was associated with a survival advantage. Reoperation should be considered in patients with tumours located in low eloquence areas and good clinical condition.

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RECIST/CA-125 progression-free survival and the role of CA-125 surveillance in the phase III PAOLA-1/ENGOT-ov25 trial evaluating maintenance olaparib plus bevacizumab in patients with newly diagnosed advanced high-grade ovarian carcinoma

Gynecologic Oncology ◽

10.1016/s0090-8258(21)00775-7 ◽

2021 ◽

Vol 162 ◽

pp. S71

Author(s):

Sakari Hietanen ◽

Patricia Pautier ◽

Philipp Harter ◽

Claire Cropet ◽

Saverio Cinieri ◽

...

Keyword(s):

Ovarian Carcinoma ◽

Progression Free Survival ◽

Phase Iii ◽

Ca 125 ◽

High Grade ◽

Newly Diagnosed ◽

Free Survival

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Prognostic Value of Metabolic Tumor Volume on 11C-Methionine PET in Predicting Progression-Free Survival in High-Grade Glioma

Nuclear Medicine and Molecular Imaging ◽

10.1007/s13139-015-0362-0 ◽

2015 ◽

Vol 49 (4) ◽

pp. 291-297 ◽

Cited By ~ 23

Author(s):

Min Young Yoo ◽

Jin Chul Paeng ◽

Gi Jeong Cheon ◽

Dong Soo Lee ◽

June-Key Chung ◽

...

Keyword(s):

Prognostic Value ◽

Tumor Volume ◽

Progression Free Survival ◽

High Grade Glioma ◽

Metabolic Tumor Volume ◽

High Grade ◽

Free Survival

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Prognostic factors in progressive high-grade glial tumors treated with systemic approach: A single center experience

Journal of Oncology Pharmacy Practice ◽

10.1177/1078155220920684 ◽

2020 ◽

pp. 107815522092068

Author(s):

Ozkan Alan ◽

Tugba Akin Telli ◽

Tugba Basoglu Tuylu ◽

Rukiye Arikan ◽

Nazım Can Demircan ◽

...

Keyword(s):

Overall Survival ◽

Prognostic Factors ◽

Systemic Treatment ◽

Progression Free Survival ◽

High Grade Glioma ◽

Idh1 Mutation ◽

High Grade ◽

Free Survival ◽

Median Progression Free Survival ◽

Ecog Ps

Purpose Malignant high-grade gliomas are the most common and aggressive type of primary brain tumor, and the prognosis is generally extremely poor. In this retrospective study, we analyzed the outcome of systemic treatment in recurrent high-grade glioma patients and the impact of prognostic factors on survivals. Methods Data from 114 patients with recurrent high-grade glioma who received systemic treatment and followed in our clinic between 2012 and 2018 were retrospectively analyzed. Eastern Cooperative Oncology Group (ECOG) performance status, age, gender, histology, type of surgical resection, side effects after systemic treatment (deep vein thrombosis, hypertension, proteinuria), IDH1 and alpha thalassemia/mental retardation syndrome X-linked (ATRX) mutation status were investigated as prognostic factors for progression-free survival and overall survival. Results At the time of diagnosis, the median age was 48 (17–77) and 68% of the patients were male. Most common pathologic subtype was glioblastoma multiforme (68%). Median follow-up duration was 9.1 months (1–68 months). Median progression-free survival and overall survival were 6.2 months and 8 months, respectively. In multivariate analysis, ECOG PS, deep venous thrombosis and the presence of ATRX and IDH1 mutation were found to be independent prognostic factors for progression-free survival (p < 0.05) and, ECOG PS, the presence of ATRX and IDH1 mutation for overall survival (p < 0.05). Conclusion Our study is real life data and the median progression-free survival and overall survival rates are similar to the literature. We have found ECOG PS, presence of ATRX and IDH1 mutation to be independent prognostic factors for both progression-free survival and overall survival.

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Association of PD-L1 expression with tumor infiltrating immune cells and mutation burden in the high grade neuroendocrine carcinoma of the lung.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.8564 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. 8564-8564 ◽

Cited By ~ 2

Author(s):

Hye Sook Kim ◽

Ji-Youn Han

Keyword(s):

Neuroendocrine Carcinoma ◽

Immune Cells ◽

Progression Free Survival ◽

Large Cell ◽

High Grade ◽

Free Survival ◽

Mutation Burden ◽

Programmed Death ◽

Significant Difference

8564 Background: Large cell neuroendocrine carcinoma (LCNEC) and small cell lung cancer (SCLC) are recognized as high grade neuroendocrine carcinoma of the lung and remain among the most fatal malignancies. Programmed death-ligand 1 (PD-L1) is expressed in a group of cancers that may be suitable for specific immunotherapy. We retrospectively investigated PD-L1 expression in tumor cells (TC) and tumor infiltrating immune cells (IC) and correlated this with mutation burden and clinical outcome. Methods: A total of 192 patients with LCNEC (n = 72) and SCLC (n = 120) were explored. PD-L1 expression was scored by immunohistochemistry in TC and IC. We used the Ion AmpliSeq Comprehensive Cancer Panel to identify mutation in all exons in 409 cancer-related genes. Results: The overall prevalence of PD-L1 expression on TC was 15.1 % (29/192). No significant difference was observed between LCNEC and SCLC (16.7% vs. 14.2%, p = 0.365). Tumor-infiltrating IC and PD-L1 positive immune cells (IC) were observed in 34.4% (66/192) and 31.3% (60/192), respectively. The prevalence of tumor-infiltrating IC and PD-L1 expression on IC were significantly higher in LCNEC compared to SCLC (57.6% vs. 23.3%, p < .001; 45.8% vs. 22.5%, p = .001, respectively). Tumor-infiltrating IC and PD-L1 expression on IC were correlated with higher nonsynonymous mutational load (p = 0.048 and 0.038, respectively). Tumor-infiltrating immune cells (median 11.3 vs. 6.8 months, p = 0.005), and its correlated PD-L1 expression on IC (median 11.3 vs. 7.0 months, p = 0.024) were related with better progression free survival. There was no relevance between biomarker status and overall survival. Conclusions: These findings suggest that the PD-1/PD-L1 pathway is activated in a fraction of HGNEC of lung with correlating higher mutational burden. Further studies are needed to determine the PD-L1 expression and correlated clinical features to refine role of anti-PD1 treatments in these patient population.

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Prognostic Role of c-Met Overexpression in High Grade Glioma: a Meta-analysis

10.1101/695775 ◽

2019 ◽

Author(s):

Bo Wu ◽

Yuhan Ma ◽

Sheng Zhong ◽

Junliang Ge ◽

Shanshan Jiang ◽

...

Keyword(s):

Meta Analysis ◽

Progression Free Survival ◽

High Grade Glioma ◽

High Grade ◽

Poor Overall Survival ◽

Prognostic Analysis ◽

Oncomine Database ◽

Strongly Connected ◽

The Relationship

AbstractObjectivesThis study aims to assess the relationship between the expression of c-Met and the prognosis of high grade glioma patients.MethodThe MET proto-oncogene encoded c-Met protein. The gene expression data of 325 patients were downloaded from CGGA. The Oncomine database analysis and the prognosis analysis were conducted. Besides, meta-analysis was also performed to confirm the conclusion.ResultOncomine database was identified and analyzed and results showed that the MET copy number was obviously higher in glioblastoma than normal tissue consistently (p<0.001). The prognostic analysis of 325 high grade glioma samples showed that high c-Met expression patients had poor overall survival (OS) and progression free survival (PFS) than the low c-Met expression patients dramatically (HR, 2.223; 95% CI: 1.662 to 2.974; P<0.0001 and HR, 2.089; 95% CI: 1.578 to 2.770; P<0.0001). 6 studies involving 503 patients were included in the meta-analysis. The pooled results indicated that the high expression of c-Met was not significantly associated with OS (HR =1.01, 95% CI:0.93-1.09), but strongly connected with shorter PFS (HR =1.92, 95% CI:1.42-2.58, p<0.01).Conclusionc-Met overexpression has correlation with poor prognosis of high grade glioma patients.

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Role of Bevacizumab in High-grade Meningiomas

10.21203/rs.3.rs-786263/v1 ◽

2021 ◽

Author(s):

Xuexue Bai ◽

xiangyu wang ◽

Yiyao Cao

Keyword(s):

Progression Free Survival ◽

Rank Test ◽

High Grade ◽

Chi Square ◽

Free Survival ◽

Log Rank Test ◽

Peritumoral Brain Edema ◽

Chi Square Test

Abstract Background: To explore the role of bevacizumab (BV) in High-grade Meningiomas (HGMs) undergoing surgical treatment.Methods: Review the clinical data of 139 patients with HGMs and divide them into BV group and non- BV group according to whether they receive BV treatment. Then we compared the progression-free survival (PFS) and overall survival (OS) of the two groups.Results: The Chi-square test showed significant differences between the BV group and the non-BV group in terms of 12-month PFS (PFS-12), 36-month PFS (PFS-36), median PFS (M-PFS), 12-month OS (OS-12), 36-month OS (OS-36), and median OS (M-OS). However, there was no statistical difference between the BV group and the non-BV group in terms of 6-month PFS (PFS-6), 60-month PFS (PFS-60), and 60-month OS (OS-60). The log-rank test indicated significant differences in PFS and OS between the BV group and the non-BV group.Conclusion: The role of BV in patients with HGMs is to relieve the symptoms of peritumoral brain edema (PTBE) and prolong PFS and OS. However, whether increasing the dose of BV after surgery can improve the long-term PFS and OS of patients with HGMs needs further research.

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Anlotinib Alone or in Combination With Temozolomide in the Treatment of Recurrent High-Grade Glioma: A Retrospective Analysis

Frontiers in Pharmacology ◽

10.3389/fphar.2021.804942 ◽

2021 ◽

Vol 12 ◽

Author(s):

Qunying Yang ◽

Chengcheng Guo ◽

Xiaoping Lin ◽

Lili Luo ◽

Zhenqiang He ◽

...

Keyword(s):

Overall Survival ◽

Objective Response ◽

Progression Free Survival ◽

High Grade Glioma ◽

Rank Test ◽

Cancer Center ◽

High Grade ◽

Karnofsky Score ◽

Free Survival ◽

Grade 3

Background: Anlotinib is a multi-target anti-angiogenic agent. This retrospective study aimed to evaluate the efficacy and safety of anlotinib alone or in combination with temozolomide for the treatment of recurrent high-grade glioma.Materials and Methods: The clinical data of patients with recurrent high-grade glioma treated with anlotinib alone or in combination with temozolomide in our cancer center were collected and analyzed. Treatment response was evaluated according to the response assessment for neuro-oncology criteria. Progression-free survival, progression-free survival at 6 months, overall survival, and overall survival at 12 months were evaluated by Kaplan–Meier method and compared by log-rank test.Results: Between August 2019 and December 2020, 31 patients with recurrent high-grade glioma (21 of grade 4 and 10 of grade 3) were enrolled in this study. Seventeen patients received anlotinib alone and 14 received anlotinib plus temozolomide. All patients were heavily treated, the median lines of previous treatments were 2, and the median Karnofsky score was 60. At the data cutoff date, the median progression-free survival was 4.5 months and the progression-free survival at 6 months was 43.5%. The median overall survival was 7.7 months, and the overall survival at 12 months was 26.7%. The progression-free survival at 6 months and the overall survival at 12 months for 21 patients with grade 4 glioma was 40.2 and 27.9%, respectively. The tumor objective response rate was 41.9% in all patients and 33.3% in patients with grade 4 glioma. No grade 3 or worse treatment-related adverse events were recorded during the treatment.Conclusion: Anlotinib alone or in combination with temozolomide showed encouraging efficacy and favorable tolerability in patients with recurrent high-grade glioma who had been heavily treated.

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The Combination of Carmustine Wafers and Fotemustine in Recurrent Glioblastoma Patients: A Monoinstitutional Experience

BioMed Research International ◽

10.1155/2014/678191 ◽

2014 ◽

Vol 2014 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Giuseppe Lombardi ◽

Alessandro Della Puppa ◽

Fable Zustovich ◽

Ardi Pambuku ◽

Patrizia Farina ◽

...

Keyword(s):

Progression Free Survival ◽

Recurrent Glioblastoma ◽

Gross Total Resection ◽

Total Resection ◽

Free Survival ◽

Multimodal Strategy ◽

Carmustine Wafers ◽

Second Surgery ◽

Grade 3 ◽

Clinical Conditions

Background. To date, there is no standard treatment for recurrent glioblastoma. We analyzed the feasibility of second surgery plus carmustine wafers followed by intravenous fotemustine.Methods. Retrospectively, we analyzed patients with recurrent glioblastoma treated with this multimodal strategy.Results. Twenty-four patients were analyzed. The median age was 53.6; all patients had KPS between 90 and 100; 19 patients (79%) performed a gross total resection > 98% and 5 (21%) a gross total resection > 90%. The median progression-free survival from second surgery was 6 months (95% CI 3.9–8.05) and the median OS was 14 months (95% CI 11.1–16.8 months). Toxicity was predominantly haematological: 5 patients (21%) experienced grade 3-4 thrombocytopenia and 3 patients (12%) grade 3-4 leukopenia.Conclusion. This multimodal strategy may be feasible in patients with recurrent glioblastoma, in particular, for patients in good clinical conditions.

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High-grade glioma of central nervous system: Single center treatment experience.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e14040 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e14040-e14040

Author(s):

Nur Olgun ◽

Deniz Kızmazoğlu ◽

Batuhan Özdoğar ◽

Emre Çeçen ◽

Ceren Kızmazoğlu ◽

...

Keyword(s):

Overall Survival ◽

Survival Rates ◽

Progression Free Survival ◽

High Grade Glioma ◽

High Grade ◽

Event Free Survival ◽

Free Survival ◽

Median Progression Free Survival ◽

One Year ◽

Overall Survival Rates

e14040 Background: To evaluate characteristics and treatment responses of patients with high grade gliomas (HGG) in our center Methods: Medical files of patients with malignant CNS tumors between 1987-2020 were analyzed retrospectively. There were 44 patients with HGG. Results: Diagnosis of patients as follows: 21 pons glioma, 2 anaplastic astrocytoma, 11 anaplastic ependimoma, 7 glioblastoma multiforme, 1 glioblastoma, 2 gliomatosis cerebri. The median age at diagnosis was 6,5 yrs (7 – 17 yrs), M/F:25/19. Age distrubution: <5 yrs 12 patients, 5-10 yrs 18 patients, 10-18 yrs 14 patients. The most frequent complaints for pons gliomas: cranial nerve paralysis (52%), visial impairment (48%), headache (38%), power loss (43%) and speech disorder (30%). Surgery was performed to extrinsic component of mass in 3 patients of pons gliomas. For other HGG: 7 subtotal resection and 16 gross total resection had performed. Seven patients died before RT. And other 37 patients received radiotherapy. RT total doses varied between 50-60 Gy. Seven patients were not received chemotherapy, 3 of them died before chemo, and others received only RT. Chemotherapy protocoles were changed over the years: For pons gliomas, MOPP (Mechlorethamine, vincristine, prednisone, procarbazine) in 3 patients, NOPP (nitrosourea, vincristine, prednisone, procarbazine) in 2 patients, only ICE (Ifosfamide, carboplatin, cisplatin) in five patients, oral cyclophosphamide in one patient, temozolamide in one patient and temo + bevacizumab in one patient. Last 3 patients received nimotuzumab-vinorelbine after ICE and temo. For other HGGs, platin based regimens used fort he first line treatment. Temozolamide-bevacizumab, irinotecan-temsirolimus combinations were the other options as second and also third line treatments. Median progression free survival time was 6 mos (2 weeks -25 mos) for pons gliomas, for other gliomas median progression free survival time was 14 mos (0 -74 mos). For pons gliomas: Event free survival rate for 6 mos was 75%, for one year was 17%, One year, 18 mos, and two years overall survival rates were 84%, 52% and 10% respectively. For other HGGs: Event free survival rate for one year and two years were 57% and 17% respectively. One year and two years overall survival rates were 73% and 36% respectively. Conclusions: High grade glioma is a group of tumor in which still the helplessness experienced in treatment. Despite radiotherapy and chemotherapy, prognosis is very poor. The progression free and overall survival rates of patients were similar to literature. With new developments in molecular pathology, as the use of molecular target therapies, the progression free survival rates newly will improve.

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