Reporting last week in the Journal of Clinical Oncology, Dr. Curran and a team of American and Canadian researchers, in conjunction with the Philadelphia-based Radiation Therapy Oncology Group (RTOG), a federally-supported clinical trials organization, found that among 289 patients with either anaplastic oligodendroglioma or anaplastic oligoastrocytoma receiving either a combination of three chemotherapy drugs with radiation or radiation alone, those whose tumors had deletions in chromosome locations 1p and 19q tended to live nearly two and a half times longer than those patients without the missing chromosome portions. The “median survival time” of patients with the deletions was greater than seven years, meaning that one-half lived at least that long. For those with tumors lacking such deletions, one-half lived at least 2.8 years.
“Leukemias used to be the only cancers where chromosomal deletions were part of the treatment decision-making process,” says Dr. Curran, who is also clinical director of the Kimmel Cancer Center at Jefferson. “Now, testing for such deletions in tumors should become mandatory for at least these types of gliomas.”
In the study, 147 patients received the chemotherapy and radiation, while 142 were given only radiation. These rare, malignant tumors can be effectively treated, though seldom “cured” with surgery and radiation. One controversy, explains Dr. Curran, was whether or not adding chemotherapy early in the treatment will help individuals live longer. Most thought that chemotherapy would be beneficial.
However, the researchers found little difference in survival after three years between the two groups. While the group who received chemotherapy and radiation lived nearly a year longer without evidence of the cancer growing, nearly two-thirds of those patients experienced significant toxic side effects from the treatment.
Dr. Curran explains that there was some indirect evidence that showed that individuals with these types of tumors who had chromosomal deletions fared better. When the scientists compared the patients who had deletions and those who did not, they found stunning results.
“While finding unexpectedly that adding chemotherapy didn’t help survival, equally important was the fact that we confirmed in a multicenter trial that the 1p and/or 19q deletion was highly predictive and prognostic of patient outcome, whether the patient received radiation and chemotherapy or radiation alone,” Dr. Curran says. “Whether the patient had one or both deletions, the survival is much better.”
In the same journal issue, a European team showed nearly identical results in a similar trial. Both trials showed such deletions were predictive of survival, Dr. Curran says.
“These two studies together have shifted the way we think of anaplastic or grade three gliomas,” he says. “Up until now we’ve categorized them based on histologic appearance. We are now categorizing them according to chromosomal deletion status.”
“That’s actually more predictive than what they look like under the microscope,” Dr. Curran says. “Those who have no chromosomal deletions have outcomes not all that different than the grade four glioblastomas, a much more deadly brain tumor. Those with both deletions are a totally different group of patients.”
“Testing for chromosomal deletions should be a mandatory part now of the management of these patients based on these two trials.”
“There has been a shift in clinical trial design in the last year,” he says. “Now in patients with gliomas, we are going to apply this to future study design and probably treatment recommendations based on chromosomal deletions. I think more and more centers will begin to use such diagnostic genetics.”
Steve Benowitz | EurekAlert!
New vaccine production could improve flu shot accuracy
25.07.2017 | Duke University
Chances to treat childhood dementia
24.07.2017 | Julius-Maximilians-Universität Würzburg
Strong light-matter coupling in these semiconducting tubes may hold the key to electrically pumped lasers
Light-matter quasi-particles can be generated electrically in semiconducting carbon nanotubes. Material scientists and physicists from Heidelberg University...
Fraunhofer IPA has developed a proximity sensor made from silicone and carbon nanotubes (CNT) which detects objects and determines their position. The materials and printing process used mean that the sensor is extremely flexible, economical and can be used for large surfaces. Industry and research partners can use and further develop this innovation straight away.
At first glance, the proximity sensor appears to be nothing special: a thin, elastic layer of silicone onto which black square surfaces are printed, but these...
3-D shape acquisition using water displacement as the shape sensor for the reconstruction of complex objects
A global team of computer scientists and engineers have developed an innovative technique that more completely reconstructs challenging 3D objects. An ancient...
Physicists have developed a new technique that uses electrical voltages to control the electron spin on a chip. The newly-developed method provides protection from spin decay, meaning that the contained information can be maintained and transmitted over comparatively large distances, as has been demonstrated by a team from the University of Basel’s Department of Physics and the Swiss Nanoscience Institute. The results have been published in Physical Review X.
For several years, researchers have been trying to use the spin of an electron to store and transmit information. The spin of each electron is always coupled...
What is the mass of a proton? Scientists from Germany and Japan successfully did an important step towards the most exact knowledge of this fundamental constant. By means of precision measurements on a single proton, they could improve the precision by a factor of three and also correct the existing value.
To determine the mass of a single proton still more accurate – a group of physicists led by Klaus Blaum and Sven Sturm of the Max Planck Institute for Nuclear...
21.07.2017 | Event News
19.07.2017 | Event News
12.07.2017 | Event News
25.07.2017 | Physics and Astronomy
25.07.2017 | Earth Sciences
25.07.2017 | Life Sciences