The role of adjuvant chemotherapy in patients with H3K27 altered diffuse midline gliomas : a multicentric retrospective study
© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature..
PURPOSE: Adult Diffuse midline glioma (DMG) is a very rare disease. DMGs are currently treated with radiotherapy and chemotherapy even if only a few retrospective studies assessed the impact on overall survival (OS) of these approaches.
METHODS: We carried out an Italian multicentric retrospective study of adult patients with H3K27-altered DMG to assess the effective role of systemic therapy in the treatment landscape of this rare tumor type.
RESULTS: We evaluated 49 patients from 6 Institutions. The median age was 37.3 years (range 20.1-68.3). Most patients received biopsy as primary approach (n = 30, 61.2%) and radiation therapy after surgery (n = 39, 79.6%). 25 (51.0%) of patients received concurrent chemotherapy and 26 (53.1%) patients received adjuvant temozolomide. In univariate analysis, concurrent chemotherapy did not result in OS improvement while adjuvant temozolomide was associated with longer OS (21.2 vs. 9.0 months, HR 0.14, 0.05-0.41, p < 0.001). Multivariate analysis confirmed the role of adjuvant chemotherapy (HR 0.1, 95%CI: 0.03-0.34, p = 0.003). In patients who progressed after radiation and/or chemotherapy the administration of a second-line systemic treatment had a significantly favorable impact on survival (8.0 vs. 3.2 months, HR 0.2, 95%CI 0.1-0.65, p = 0.004).
CONCLUSION: In our series, adjuvant treatment after radiotherapy can be useful in improving OS of patients with H3K27-altered DMG. When feasible another systemic treatment after treatment progression could be proposed.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:167 |
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| Enthalten in: |
Journal of neuro-oncology - 167(2024), 1 vom: 25. März, Seite 145-154 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Di Nunno, Vincenzo [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 29.03.2024 Date Revised 29.03.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s11060-024-04589-3 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM369468279 |
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| 100 | 1 | |a Di Nunno, Vincenzo |e verfasserin |4 aut | |
| 245 | 1 | 4 | |a The role of adjuvant chemotherapy in patients with H3K27 altered diffuse midline gliomas |b a multicentric retrospective study |
| 264 | 1 | |c 2024 | |
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| 500 | |a Date Revised 29.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature. | ||
| 520 | |a PURPOSE: Adult Diffuse midline glioma (DMG) is a very rare disease. DMGs are currently treated with radiotherapy and chemotherapy even if only a few retrospective studies assessed the impact on overall survival (OS) of these approaches | ||
| 520 | |a METHODS: We carried out an Italian multicentric retrospective study of adult patients with H3K27-altered DMG to assess the effective role of systemic therapy in the treatment landscape of this rare tumor type | ||
| 520 | |a RESULTS: We evaluated 49 patients from 6 Institutions. The median age was 37.3 years (range 20.1-68.3). Most patients received biopsy as primary approach (n = 30, 61.2%) and radiation therapy after surgery (n = 39, 79.6%). 25 (51.0%) of patients received concurrent chemotherapy and 26 (53.1%) patients received adjuvant temozolomide. In univariate analysis, concurrent chemotherapy did not result in OS improvement while adjuvant temozolomide was associated with longer OS (21.2 vs. 9.0 months, HR 0.14, 0.05-0.41, p < 0.001). Multivariate analysis confirmed the role of adjuvant chemotherapy (HR 0.1, 95%CI: 0.03-0.34, p = 0.003). In patients who progressed after radiation and/or chemotherapy the administration of a second-line systemic treatment had a significantly favorable impact on survival (8.0 vs. 3.2 months, HR 0.2, 95%CI 0.1-0.65, p = 0.004) | ||
| 520 | |a CONCLUSION: In our series, adjuvant treatment after radiotherapy can be useful in improving OS of patients with H3K27-altered DMG. When feasible another systemic treatment after treatment progression could be proposed | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Adjuvant treatment | |
| 650 | 4 | |a Adult DMG | |
| 650 | 4 | |a Concomitant chemotherapy | |
| 650 | 4 | |a DMG | |
| 650 | 4 | |a Diffuse midline glioma | |
| 650 | 4 | |a H3K27 altered glioma | |
| 650 | 4 | |a Radiotherapy | |
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| 650 | 7 | |a YF1K15M17Y |2 NLM | |
| 650 | 7 | |a Antineoplastic Agents, Alkylating |2 NLM | |
| 650 | 7 | |a Dacarbazine |2 NLM | |
| 650 | 7 | |a 7GR28W0FJI |2 NLM | |
| 700 | 1 | |a Lombardi, Giuseppe |e verfasserin |4 aut | |
| 700 | 1 | |a Simonelli, Matteo |e verfasserin |4 aut | |
| 700 | 1 | |a Minniti, Giuseppe |e verfasserin |4 aut | |
| 700 | 1 | |a Mastronuzzi, Angela |e verfasserin |4 aut | |
| 700 | 1 | |a Di Ruscio, Valentina |e verfasserin |4 aut | |
| 700 | 1 | |a Corrà, Martina |e verfasserin |4 aut | |
| 700 | 1 | |a Padovan, Marta |e verfasserin |4 aut | |
| 700 | 1 | |a Maccari, Marta |e verfasserin |4 aut | |
| 700 | 1 | |a Caccese, Mario |e verfasserin |4 aut | |
| 700 | 1 | |a Simonetti, Giorgia |e verfasserin |4 aut | |
| 700 | 1 | |a Berlendis, Arianna |e verfasserin |4 aut | |
| 700 | 1 | |a Farinotti, Mariangela |e verfasserin |4 aut | |
| 700 | 1 | |a Pollo, Bianca |e verfasserin |4 aut | |
| 700 | 1 | |a Antonelli, Manila |e verfasserin |4 aut | |
| 700 | 1 | |a Di Muzio, Antonio |e verfasserin |4 aut | |
| 700 | 1 | |a Dipasquale, Angelo |e verfasserin |4 aut | |
| 700 | 1 | |a Asioli, Sofia |e verfasserin |4 aut | |
| 700 | 1 | |a De Biase, Dario |e verfasserin |4 aut | |
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| 700 | 1 | |a Silvani, Antonio |e verfasserin |4 aut | |
| 700 | 1 | |a Franceschi, Enrico |e verfasserin |4 aut | |
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