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01-01-2019 | Clinical Study

Eighty percent survival rate at 15 years for 1p/19q co-deleted oligodendroglioma treated with upfront chemotherapy irrespective of tumor grade

Authors: Yasuo Iwadate, Tomoo Matsutani, Ayaka Hara, Seiichiro Hirono, Shiro Ikegami, Masayoshi Kobayashi, Daisuke Ito, Daisuke Kawauchi, Kentaro Horiguchi, Ado Tamiya, Yoshinori Higuchi

Published in: Journal of Neuro-Oncology | Issue 1/2019

Abstract

Introduction

Chromosomes 1p/19q co-deletion is a robust molecular marker for the diagnosis of oligodendroglial tumors, and has been included in the 2016 WHO modified classification. Although treatment for oligodendroglioma is controversial, upfront chemotherapy is regarded as one of the treatment option for low-grade tumor. We have treated all the 1p/19q co-deleted oligodendrogliomas, both grades II and III, with upfront chemotherapy without conventional radiotherapy for 20 years. The clinical experience from this trial may be suggestive for understanding of the biological features of oligodendroglioma with 1p/19q co-deletion toward precision medicine.

Methods

This is a long-term retrospective data of the non-selected patients with 1p/19q co-deleted oligodendrogliomas uniformly treated with up-front chemotherapy. Seventy consecutive patients (48 with grade II and 22 with grade III tumors) were included.

Results

The median follow-up period was 13 years. The 5-, 10-, and 15-year progression-free survival (PFS) rates were 85.7%, 54.8%, and 31.5%, respectively, and the median PFS was 146 months. In most cases, tumor recurrence was remained local and could be controlled by salvage surgery and/or chemotherapy. The 5-, 10-, and 15-year overall survival (OS) rates were 96.8%, 88.7%, and 80.0%, respectively, and the median OS was not reached. These survival data compared favorably with previous large clinical studies employing radiotherapy. Tumor grades based on World Health Organization classification, extent of surgery, and age affected neither PFS nor OS. Most patients were able to return to their premorbid social life.

Conclusions

The long-term results drawn from 20-years of single institution experience show that the patients with 1p/19q co-deleted oligodendrogliomas can be successfully treated with up-front chemotherapy alone without compromising OS.

Reifenberger G, Wirsching HG, Knobbe-Thomsen CB, Weller M (2017) Advances in the molecular genetics of gliomas—implications for classification and therapy. Nat Rev Clin Oncol 14:434–452CrossRefPubMed

Mason WP, Krol GS, DeAngelis LM (1996) Low-grade oligodendrogliomas respond to chemotherapy. Neurology 46:203–207CrossRefPubMed

Celli P, Nofrone I, Palma L, Cantore G, Fortuna A (1994) Cerebral oligodendroglioma: prognostic factors and life history. Neurosurgery 35:1018–1034CrossRefPubMed

Leonardi MA, Lumenta CB (2001) Oligodendrogliomas in CT/MR-era. Acta Neurochir 143:1195–1203CrossRefPubMed

Lebrun C, Fontaine D, Ramaioli A et al (2004) Long-term outcome of oligodendrogliomas. Neurology 62:1783–1787CrossRefPubMed

Ozyigit G, Onal C, Gurkaynak M, Soylemezoklu F, Zorlu F (2005) Postoperative radiotherapy and chemotherapy in the management of oligodendroglioma: single institutional review of 88 patiengts. J Neurooncol 75:189–193CrossRefPubMed

Rusthoven CG, Carlson JA, Waxweiler TV et al (2014) The impact of adjuvant radiation therapy for high-grade gliomas by histology in the United States population. Int J Radiat Oncol Biol Phys 90:894–902CrossRefPubMed

Wick W, Roth P, Hartmann C et al (2016) Long-term analysis of the NOA-04 randomized phase III trial of sequential radiochemotherapy of anaplastic glioma with PCV or temozolomide. Neuro Oncol 18:1529–1537PubMedPubMedCentral

Iwadate Y, Fukuda K, Matsutani T, Saeki N (2016) Intrinsic protective mechanisms of neuron-glia network against glioma invasion. J Clin Neurosci 26:19–25CrossRefPubMed

10.

Postma TJ, van Groeningen CJ, Witjes RJ, Weerts JG, Kralendonk JH, Heimans JJ (1998) Neurotoxicity of combination chemotherapy with procarbazine, CCNU and vincristine (PCV) for recurrent glioma. J Neurooncol 38:69–75CrossRefPubMed

11.

Behin A, Hoang-Xuan K, Carpentier AF, Delattre J-Y (2003) Primary brain tumors in adults. Lancet 361:323–331CrossRefPubMed

12.

Iwadate Y, Matsutani T, Shinozaki N, Saeki N (2011) Anaplastic oligodendroglial tumors harboring 1p/19q deletion can be successfully treated without radiotherapy. Anticancer Res 31:4475–4479PubMed

13.

Caincross G, Macdonald D, Ludwin S et al (1994) Chemotherapy for anaplastic oligodendroglioma. J Clin Oncol 12:2013–2021CrossRef

14.

Bromberg JEC, van den Bent MJ (2009) Oligodendrogliomas: molecular biology and treatment. Oncologist 14:155–163CrossRefPubMed

15.

Baumert BG, Hegi ME, van den Bent MJ et al (2016) Temozolomide chemotherapy versus radiotherapy in high-risk low-grade glioma (EORTC 22033–26033): a randomised, open-label, phase 3 intergroup study. Lancet Oncol 17(11):1521–1532CrossRefPubMedPubMedCentral

16.

Louis DN, Perry A, Reifenberger G et al (2016) The 2016 World Health Organization classification of tumors of the central nervous system: a summary. Acta Neuropathol 131:803–820CrossRefPubMed

17.

Giannini C, Burger PC, Berkey BA et al (2008) Anaplastic oligodendroglial tumors: refining the correlation among histopathology, 1p 19q deletion and clinical outcome in Intergroup Radiation Therapy Oncology Group Trial 9402. Brain Pathol 18:360–369CrossRefPubMed

18.

Gadji M, Fortin D, Tsanaclis AM et al (2009) Is 1p/19q deletion a diagnostic marker of oligodendrogliomas ? Cancer Genet Cytogenet 194:12–22CrossRefPubMed

19.

Jenkins RB, Blair H, Ballman KV et al (2006) A t(1; 19)(q10; p10) mediates the combined deletions of 1p and 19q and predicts a better prognosis of patients with oligodendroglioma. Cancer Res 66:9852–9861CrossRefPubMed

20.

Cairncross JG, Macdonald DR, Ramsay DA (1992) Aggressive oligodendroglioma: a chemosensitive tumor. Neurosurgery 31:78–82PubMed

21.

Ino Y, Cairncross JG, Louis DN et al (2001) Molecular subtypes of anaplastic oligodendroglioma: implications for patient management at diagnosis. Clin Cancer Res 7:839–845PubMed

22.

DeAngelis LM, Delattre JY, Posner JB (1989) Radiation-induced dementia in patients cured of brain metastases. Neurology 39:789–796CrossRefPubMed

23.

Chang EL, Wefel JS, Hess KR et al (2009) Neurocognition in patients with brain metastases treated with radiosurgery or radiosurgery plus whole-brain irradiation: a randomized controlled trial. Lancet Oncol 10:1037–1044CrossRefPubMed

24.

Douw L, Klein M, Fagel SS et al (2009) Cognitive and radiological effects of radiotherapy in patients with low-grade glioma: long-term follow-up. Lancet Neurol 8:810–818CrossRefPubMed

25.

Abrey LE, Louis DN, Paleologos N et al (2007) Survey of treatment recommendation for anaplastic oligodendroglioma. Neuro-oncology 9:314–318CrossRefPubMedPubMedCentral

26.

Panageas KS, Iwamoto FM, Cloughesy TM et al (2012) Initial treatment patterns over time for anaplastic oligodendroglial tumors. Neuro-oncology 14:761–767CrossRefPubMedPubMedCentral

27.

Lassman AB, Iwamoto FM, Cloughesy TM et al (2011) International retrospective study of over 1000 adults with anaplastic oligodendroglial tumors. Neuro-oncology 13:649–659CrossRefPubMedPubMedCentral

28.

Lecavalier-Barsoum M, Quon H, Abdulkarim B (2014) Adjuvant treatment of anaplastic oligodendrogliomas and oligoastrocytomas. Cochrane Database Syst Rev 15(5):CD007104

29.

Taliansky-Aronov A, Bokstein F, Lavon I et al (2006) Temozolomide treatment for newly diagnosed anaplastic oligodendrogliomas: a clinical efficacy trial. J Neurooncol 79:153–157CrossRefPubMed

30.

Thomas AA, Abrey LE, Terziev R, Raizer J, Omuro A et al (2017) Multicenter phase II study of temozolomide and myeloablative chemotherapy with autologous stem cell transplant for newly diagnosed anaplastic oligodendroglioma. Neuro-oncology 19:1380–1390CrossRefPubMedPubMedCentral

31.

Abrey LE, Childs BH, Paicologos Z et al (2006) High-dose chemotherapy with stem cell rescue as an initial therapy for anaplastic oligodendroglioma: long-term follow-up. Neuro-oncology 8:183–188CrossRefPubMedPubMedCentral

32.

Higuchi Y, Iwadate Y, Yamaura A (2004) Treatment of low-grade oligodendroglial tumors without radiotherapy. Neurology 63:2384–2386CrossRefPubMed

33.

Iwadate Y, Matsutani T, Hasegawa Y et al (2011) Favorable long-term outcome of low-grade oligodendrogliomas irrespective of 1p/19q status when treated without radiotherapy. J Neurooncol 102:443–449CrossRefPubMed

34.

Ty AU, See SJ, Rao JP, Khoo JB, Wong MC (2006) Oligodendroglial tumor chemotherapy using “decreased-dose-intensity” PCV: a Singapore experience. Neurology 66:247–249CrossRefPubMed

35.

Sunyach MP, Jouvet A, Perol D et al (2007) Role of exclusive chemotherapy as first line treatment in oligodendroglioma. J Neurooncol 85:319–328CrossRefPubMed

36.

Taal W, van der Rijt CC, Dinjens WN et al (2015) Treatment of low-grade oligodendroglial tumors with upfront procarbazine, lomustine, and vincristine chemotherapy with long follow-up: a retrospective cohort study with growth kinetics. J Neurooncol 121:365–372CrossRefPubMed

37.

van den Bent MJ, Brandes AA, Taphoorn MJ et al (2013) Adjuvant procarbazine, lomustine, and vincristine chemotherapy in newly diagnosed anaplastic oligodendroglioma: long-term follow-up of EORTC Brain Tumor Group study 26951. J Clin Oncol 31:344–350CrossRefPubMed

38.

Cairncross G, Wang M, Shaw E et al (2013) Phase III trial of chemoradiotherapy for anaplastic oligodendroglioma: long-term results of RTOG 9402. J Clin Oncol 31:337–343CrossRefPubMed

Title: Eighty percent survival rate at 15 years for 1p/19q co-deleted oligodendroglioma treated with upfront chemotherapy irrespective of tumor grade
Authors: Yasuo Iwadate
Tomoo Matsutani
Ayaka Hara
Seiichiro Hirono
Shiro Ikegami
Masayoshi Kobayashi
Daisuke Ito
Daisuke Kawauchi
Kentaro Horiguchi
Ado Tamiya
Yoshinori Higuchi
Publication date: 01-01-2019
Publisher: Springer US
Published in: Journal of Neuro-Oncology / Issue 1/2019
Print ISSN: 0167-594X
Electronic ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-018-03027-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Eighty percent survival rate at 15 years for 1p/19q co-deleted oligodendroglioma treated with upfront chemotherapy irrespective of tumor grade

Abstract

Introduction

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

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