Publicaciones científicas

Gliomatosis cerebri in children: A poor prognostic phenotype of diffuse gliomas with a distinct molecular profile

08-may-2024 | Revista: Neuro-Oncology

Gunther Nussbaumer  1 , Martin Benesch  1 , Yura Grabovska  2 , Alan Mackay  2 , David Castel  3   4 , Jacques Grill  3   4 , Marta M Alonso  5   6   7 , Manila Antonelli  8 , Simon Bailey  9 , Joshua N Baugh  10 , Veronica Biassoni  11 , Mirjam Blattner Johnson  12   13 , Alberto Broniscer  14 , Andrea Carai  15 , Giovanna Stefania Colafati  16 , Niclas Colditz  17 , Selim Corbacioglu  18 , Shauna Crampsie  2 , Natacha Entz-Werle  19   20 , Matthias Eyrich  21 , Lea L Friker  22 , Michael C Frühwald  23 , Maria Luisa Garrè  24 , Nicolas U Gerber  25 , Felice Giangaspero  8 , Maria J Gil-da-Costa  26 , Norbert Graf  27 , Darren Hargrave  28 , Peter Hauser  29 , Ulrich Herrlinger  30 , Marion Hoffmann  17 , Esther Hulleman  10 , Elisa Izquierdo  2 , Sandra Jacobs  31 , Michael Karremann  32 , Antonis Kattamis  33 , Rejin Kebudi  34 , Rolf-Dieter Kortmann  35 , Robert Kwiecien  36 , Maura Massimino  11 , Angela Mastronuzzi  37 , Evelina Miele  37 , Giovanni Morana  38 , Claudia M Noack  39 , Virve Pentikainen  40 , Thomas Perwein  1 , Stefan M Pfister  12   41   42   43 , Torsten Pietsch  22 , Kleoniki Roka  33 , Sabrina Rossi  44 , Stefan Rutkowski  45 , Elisabetta Schiavello  11 , Clemens Seidel  35 , Jaroslav Štěrba  46 , Dominik Sturm  12   13   42 , David Sumerauer  47 , Anna Tacke  17 , Sara Temelso  2 , Chiara Valentini  48 , Dannis van Vuurden  10 , Pascale Varlet  49 , Sophie E M Veldhuijzen van Zanten  10   50 , Maria Vinci  37 , André O von Bueren  51 , Monika Warmuth-Metz  52 , Pieter Wesseling  10   53 , Maria Wiese  15 , Johannes E A Wolff  54 , Josef Zamecnik  55 , Andrés Morales La Madrid  56 , Brigitte Bison  57   58 , Gerrit H Gielen  22 , David T W Jones  12   13 , Chris Jones  2 , Christof M Kramm  17


Background: The term Gliomatosis cerebri (GC), a radiology-defined highly infiltrating diffuse glioma, has been abandoned since molecular GC-associated features have not been established yet.

Methods: We conducted a multinational retrospective study of 104 children and adolescents with GC providing comprehensive clinical and (epi-)genetic characterization.

Results: Median overall survival (OS) was 15.5 months (interquartile range, 10.9-27.7) with a 2-years survival rate of 28%. Histopathological grading correlated significantly with median OS: CNS WHO grade II: 47.8 months (25.2-55.7); grade III: 15.9 months (11.4-26.3); grade IV: 10.4 months (8.8-14.4). By DNA methylation profiling (n=49), most tumors were classified as pediatric-type diffuse high-grade glioma (pedHGG), H3-/IDH-wildtype (n=31/49, 63.3%) with enriched subclasses pedHGG_RTK2 (n=19), pedHGG_A/B (n=6), and pedHGG_MYCN (n=5), but only one pedHGG_RTK1 case. Within the pedHGG, H3-/IDH-wildtype subgroup, recurrent alterations in EGFR (n=10) and BCOR (n=9) were identified. Additionally, we observed structural aberrations in chromosome 6 in 16/49 tumors (32.7%) across tumor types. In the pedHGG, H3-/IDH-wildtype subgroup TP53 alterations had a significant negative effect on OS.

Conclusion: Contrary to previous studies, our representative pediatric GC study provides evidence that GC has a strong predilection to arise on the background of specific molecular features (especially pedHGG_RTK2, pedHGG_A/B, EGFR and BCOR mutations, chromosome 6 rearrangements).

CITA DEL ARTÍCULO  Neuro Oncol. 2024 May 8:noae080. doi: 10.1093/neuonc/noae080