421P - Outcome and molecular characteristics of young adult patients with newly diagnosed primary glioblastoma: a study of the Society of Austrian Neuroonc...

Date 30 September 2012
Event ESMO Congress 2012
Session Poster presentation II
Topics Cancer in Young Adults
Central Nervous System Malignancies
Pathology/Molecular Biology
Presenter Christine Marosi
Authors C. Marosi1, A. Leibetseder2, M. Ackerl3, B. Flechl1, C. Sax3, A. Wöhrer4, M. Preusser5, K. Dieckmann6, J. Pichler7, S. Spiegl.kreinecker7
  • 1Medical University of Vienna, 1090 - Vienna/AT
  • 2Oncology, medizinische universität wien, 1090 - wien/AT
  • 3Internal Medicine, Medical University of Vienna, 1090 - Vienna/AT
  • 4Institute For Neurology, Medical University of Vienna, 1090 - Vienna/AT
  • 5Department Of Medicine I, Medical University of Vienna, AT-1090 - Wien/AT
  • 6Radiotherapy, medical university vienna, 1090 - vienna/AT
  • 7Neurooncology, Wagner Jauregg Spital, 4020 - linz/AT

Abstract

Background

Young age is well-known as favorable prognostic factor for patients with glioblastoma multiforme (GBM). We reviewed the outcome and molecular tumor characteristics of “young” adult patients with newly diagnosed GBM treated in two Austrian Neurooncology centers.

Patients and methods

Data of patients with histologically proven GBM diagnosed between age 18 and 40 were retrospectively analysed. All cases presented as newly diagnosed GBM without previous history of neurological disease. All were treated with standard first line therapy. IDH1-R132H mutation status was analyzed by immunohistochemistry. Moreover, tumour samples were tested for MGMT promoter methylation using methylation-specific polymerase chain reaction (MS-PCR). The primary endpoint was overall survival (OS) and time to tumour progression (TTP).

Results

We included 70 patients (36 men and 34 women; 47 from Vienna, 23 from Linz) with a median age of 33 (range 18 to 40 years) in our study. IDH1-R132H mutations were detected in 22/56 (39.3%) cases and MGMT promoter methylation in 33/54 (61.1%) cases with available tissue samples. IDH1 mutation was highly significantly associated with MGMT promoter methylation (p < 0.0001, Chi-square test). In patients with wild type IDH median TTP was 12.6 months and median OS 43.0 months, versus 22.2 months (TTP) and 50.6 months (OS) observed in patients with mutated IDH. Neither IDH1 nor MGMT status showed a statistically significant association with TTP or OS in our cohort. Of note, the social and economical situation of the young GBM patients was alarming, as only a minority of patients (17%) succeeded in staying employed after receiving the diagnosis.

Conclusions

We found a high frequency of IDH1 mutations and MGMT promoter methylation among young adult patients with primary GBM that may contribute to the generally favourable outcome associated with young age in glioblastoma patients. The social and economic coverage of glioma patients remains an unsolved socio-ethical problem.

Disclosure

All authors have declared no conflicts of interest.