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Treatment recommendations for anaplastic oligodendrogliomas that are codeleted.
Mark D Anderson1, Mark R Gilbert
1Department of Neuro-Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Oncology (Williston Park, N.Y.)
|June 21, 2013
Summary
For adult anaplastic oligodendroglioma patients with the 1p/19q codeletion, combined PCV chemotherapy and radiation therapy significantly improves outcomes compared to radiation alone. This finding validates 1p/19q codeletion as a predictive biomarker.
Area of Science:
- Neuro-oncology
- Clinical Oncology
- Molecular Diagnostics
Background:
- Anaplastic oligodendroglioma (AO) is a rare adult brain tumor.
- Previous trials showed no survival benefit for chemotherapy combined with radiotherapy over radiotherapy alone.
- The 1p/19q codeletion is a known genetic marker in AO.
Purpose of the Study:
- To evaluate the efficacy of PCV chemotherapy plus radiation therapy versus radiation therapy alone in adult AO patients.
- To validate the 1p/19q codeletion as a predictive biomarker for treatment response.
Main Methods:
- Analysis of data from Radiation Therapy Oncology Group (RTOG) 9402 and European Organisation for Research and Treatment of Cancer (EORTC) 26951 trials.
- Comparison of outcomes between patients receiving PCV chemotherapy and radiation therapy versus radiation therapy alone.
- Assessment of the 1p/19q codeletion status as a predictive biomarker.
Main Results:
- Patients with the 1p/19q codeletion who received PCV chemotherapy and radiation therapy demonstrated improved outcomes.
- The 1p/19q codeletion was validated as a predictive biomarker in AO.
- Extended follow-up revealed survival differences not apparent in initial 2006 results.
Conclusions:
- Radiotherapy alone is no longer considered appropriate for 1p/19q codeleted AO.
- PCV chemotherapy in combination with radiation therapy is a beneficial treatment for this patient group.
- Further large-scale trials are needed to address chemotherapy choices, sequencing, and dosing.
