Characteristics, outcome, and prognostic factors of young patients with central nervous system World Health Organization grade 3 oligodendrogliomas IDH-mutant and 1p/19q codeleted: A French POLA network study.

in Cancer by Alexandre Bertucci, Ondine Dufour, Romain Appay, Vincent Harlay, François Ducray, Charlotte Bronnimann, Apolline Djelad, Elisabeth Cohen-Jonathan Moyal, Mario Campone, Olivier Langlois, Mathilde Ducloie, Elodie Vauleon, Nadia Younan, Christine Desenclos, Carole Ramirez, Mehdi Touat, Ahmed Idbaih, Céline Bequet, Dominique Figarella-Branger, Caroline Dehais, Olivier Chinot, Emeline Tabouret,

TLDR

  • The study characterized patients under 40 years old with grade 3 oligodendrogliomas and found distinct clinical presentation, molecular features, and outcomes compared to older patients.
  • Young patients had more frequent seizures, less frequent genetic mutations, and better overall survival compared to older patients.

Abstract

Brain tumors represent one of the main causes of cancer-related mortality in young patients. Among them, oligodendrogliomas (OG) are adult-type diffuse gliomas with the best prognosis. Nevertheless, characterization of these tumors in the young population remains poorly documented. Our objective was to characterize the population of young adults under 40 years of age with grade 3 OG in the POLA cohort. Clinical data prospectively collected for all patients registered with grade 3 OG between April 2009 and August 2021 were extracted from the national POLA database. This study compared the patient subgroup <40 years of age to the one >40 years of age. The authors included 111 patients <40 years old and 363 patients ≥40 years old. Treatment received did not differ significantly between the two subgroups. Temporal location was more frequent in older patients (p = .009). Patients <40 years old presented more often seizure as initial symptom (p = .003). They had less frequent chromosome 9p loss (p < .001) and less CDKN2A homozygous deletion (p = .024). Median progression-free survival (PFS) was 123 months (range, 86-not reached [NR]) versus 88 months (range, 67-117) (p = .082) and median overall survival (OS) was not reached (range, 147-NR) versus 163 months (range, 137-NR) (p < .001) in younger and older subgroups, respectively. In multivariate analysis, complete or subtotal resection (p = .014) and seizure at diagnosis (p = .032) were associated with better OS. Young patients with grade 3 OG have distinct clinical presentation, molecular features, and outcomes compared to the older patients.

Overview

  • The study aimed to characterize patients under 40 years old with grade 3 oligodendrogliomas (OG) in the POLA cohort.
  • The researchers compared the clinical features, treatment, and outcomes between patients <40 years old and those ≥40 years old.
  • The primary objective was to identify distinct clinical presentation, molecular features, and outcomes of young patients with grade 3 OG.

Comparative Analysis & Findings

  • Patients <40 years old had more frequent seizures as initial symptoms (p=0.003) and less frequent chromosome 9p loss (p<0.001) and CDKN2A homozygous deletion (p=0.024) compared to those ≥40 years old.
  • Temporal location was more frequent in older patients (p=0.009), but treatment received did not differ significantly between the two subgroups.
  • Median progression-free survival was 123 months in younger patients and 88 months in older patients (p=0.082), while median overall survival was not reached for younger patients and 163 months for older patients (p<0.001).

Implications and Future Directions

  • The study highlights the importance of considering age-specific factors when diagnosing and treating patients with grade 3 OG.
  • Future research should focus on identifying genetic and molecular markers that could predict treatment response and outcome in young patients with grade 3 OG.
  • The findings suggest that young patients with grade 3 OG may benefit from more aggressive surgical resection and treatment personalized to their specific clinical and molecular features.
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