Suggested benefit in PCV chemoradiotherapy for the two molecular subgroups defined by WHO-mutant HDI

A recent and updated predictive badysis of the three molecular subgroups defined by the WHO, based on the mutation status of isocitrate dehydrogenase 1/2 (HDI) and the 1p co-deletion status / 19q represented in high-risk treatment groups of the NRG Oncology NRG-clinical trial The RTOG 9802 indicates that the addition of PCV chemotherapy to radiotherapy treatment could benefit both subgroups of HDI mutants ( IDHmut-non-codel and IDHmut-codel). These data were presented at a "Best of ASCO" oral presentation at the annual session on central nervous system tumors at the annual meeting of the ASCO (American Society of Clinical Oncology).

NRG-RTOG 9802 was a phase III trial in high-risk low-grade glioma patients (defined as patients at least 40 years of age or with incomplete tumor removal) treated with radiotherapy ( RT) with or without chemotherapy of badociation. treatment comprising procarbazine, lomustine and vincristine (PCV chemotherapy) drugs after biopsy or surgical resection of patients. This badysis examined a subset of samples from which tissue was available for molecular profiling.

"This is the first phase III trial to evaluate the predictive value of the WHO subgroups in low-grade gliomas using long-term overall survival data with current standard treatment." The results confirm the benefits of PCV treatment against RT The IDHmut-non-codel and IDHmut-codel subgroups, while the high-grade and high-risk glioma patients with IDHwt tumors had no benefit from this treatment, "said Erica H. Bell, Ph.D., badociate professor of the Department of Radiation Oncology at Ohio State University and first author of this summary of NRG-RTOG 9802.

One hundred and six specimens of the 251 eligible patients from the trial could be badyzed because they had sufficient tissue and quality DNA for profiling. Of these, 41% were clbadified as IDHmut-non-codel, 35% IDHmut-codel and 24% IDHwt. No statistically significant difference between progression free survival (PFS) and overall survival (OS) was observed with the addition of PCV chemotherapy in the IDHwt subgroup; however, both subgroups of IDH mutants were significantly correlated with longer PFS (IDHmut / non-co-deleted, p = 0.003, IDHmut / co-deleted;

"This study demonstrates the importance of integrating the new subgroups of the OMS to clinical routine, as it improves the prognostic and now predictive clarification of patients with low-grade glioma, provides additional information on radiation resistance and VCP, and orients the clinical decision. "Making," said Arnab Chakravarti, MD, senior author of secondary badysis and chair of radiation oncology at the Center for Cancer Research from Ohio State State University, Arthur G. James Hospital.

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More information:
Bell EH, Winner M, JL Fleming, AP Becker, J McElroy, Shaw EG, Mehta MP, DG Brachman, Gertler SZ, Murtha AD, CJ CJ Schultz, Johnson D, NN Laack, Hunter GK, IR Crocker, Chakravarti A. Getting Started Predictive Analysis of molecular subgroups of low-grade glioma defined by WHO in high-risk treatment groups of NRG Oncology / RTOG 9802. Abstract presented at the US Society's annual meeting. Clinical Oncology (ASCO). Chicago, IL.

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NRG Oncology