Patients with IDH1 wild type anaplastic astrocytomas exhibit worse prognosis than IDH1-mutated glioblastomas, and IDH1 mutation status accounts for the unfavorable prognostic effect of higher age: Implications for classification of gliomas

摘要: WHO grading of human brain tumors extends beyond a strictly histological system by providing basis predictive for the clinical behavior respective neoplasm. For example, patients with glioblastoma grade IV usually show less favorable course and receive more aggressive first-line treatment than anaplastic astrocytoma III. Here we provide evidence that IDH1 status is prognostic overall survival standard criteria differentiate high-grade astrocytomas. We sequenced isocitrate dehydrogenase 1 gene (IDH1) at codon 132 in 382 from NOA-04 trial prospective translational cohort study German Glioma Network. Patients astrocytomas carried mutations 60%, glioblastomas 7.2%. was most prominent single factor (RR 2.7; 95% CI 1.6–4.5) followed age, diagnosis MGMT. The sequence to poorer outcome (1) mutation, (2) (3) without mutation (4) (p < 0.0001). In this combined set both, expression were greater relevance according current classification system. Our data indicate much significance patient age due predominant occurrence younger patients. Immunohistochemistry using mutation-specific antibody recognizing R132H yielded similar results. propose complement astrocytic gliomas use molecular future trials.