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!
NIST scientists discover how to switch liver cancer cell growth from 2-D to 3-D structures
17.11.2017 | National Institute of Standards and Technology (NIST)
High speed video recording precisely measures blood cell velocity
15.11.2017 | ITMO University
The formation of stars in distant galaxies is still largely unexplored. For the first time, astron-omers at the University of Geneva have now been able to closely observe a star system six billion light-years away. In doing so, they are confirming earlier simulations made by the University of Zurich. One special effect is made possible by the multiple reflections of images that run through the cosmos like a snake.
Today, astronomers have a pretty accurate idea of how stars were formed in the recent cosmic past. But do these laws also apply to older galaxies? For around a...
Just because someone is smart and well-motivated doesn't mean he or she can learn the visual skills needed to excel at tasks like matching fingerprints, interpreting medical X-rays, keeping track of aircraft on radar displays or forensic face matching.
That is the implication of a new study which shows for the first time that there is a broad range of differences in people's visual ability and that these...
Computer Tomography (CT) is a standard procedure in hospitals, but so far, the technology has not been suitable for imaging extremely small objects. In PNAS, a team from the Technical University of Munich (TUM) describes a Nano-CT device that creates three-dimensional x-ray images at resolutions up to 100 nanometers. The first test application: Together with colleagues from the University of Kassel and Helmholtz-Zentrum Geesthacht the researchers analyzed the locomotory system of a velvet worm.
During a CT analysis, the object under investigation is x-rayed and a detector measures the respective amount of radiation absorbed from various angles....
The quantum world is fragile; error correction codes are needed to protect the information stored in a quantum object from the deteriorating effects of noise. Quantum physicists in Innsbruck have developed a protocol to pass quantum information between differently encoded building blocks of a future quantum computer, such as processors and memories. Scientists may use this protocol in the future to build a data bus for quantum computers. The researchers have published their work in the journal Nature Communications.
Future quantum computers will be able to solve problems where conventional computers fail today. We are still far away from any large-scale implementation,...
Pillared graphene would transfer heat better if the theoretical material had a few asymmetric junctions that caused wrinkles, according to Rice University...
15.11.2017 | Event News
15.11.2017 | Event News
30.10.2017 | Event News
17.11.2017 | Physics and Astronomy
17.11.2017 | Health and Medicine
17.11.2017 | Studies and Analyses