H3K27M and TERT promoter mutations are poor prognostic factors in surgical cases of adult thalamic high-grade glioma. Issue 1 (28th February 2021)

• Record Type: Journal Article
• Authors: Osada, Yoshinari; Saito, Ryuta; Shibahara, Ichiyo; Sasaki, Keisuke; Shoji, Takuhiro; Kanamori, Masayuki; Sonoda, Yukihiko; Kumabe, Toshihiro; Watanabe, Mika; Tominaga, Teiji
• Is Part Of: Neuro-oncology advances. Volume 3:Issue 1(2021)
• Publication Date: 2021-02-28
• Subjects: adult thalamic glioma -- high-grade glioma -- H3K27M -- surgical resection -- TERT promoter mutation; 616.99481
• DOI: 10.1093/noajnl/vdab038
• Languages: English
• ISSNs: 2632-2498

Abstract

Abstract: Background: Thalamic high-grade gliomas (HGGs) are rare tumors with a dismal prognosis. H3K27M and telomerase reverse transcriptase promoter ( TERTp ) mutations reportedly contribute to poor prognoses in HGG cases. We investigated the outcomes of surgically treated adult thalamic HGGs to evaluate the prognostic significance of H3K27M and TERTp mutations. Methods: We retrospectively analyzed 25 adult patients with thalamic HGG who underwent maximum surgical resection from January 1997 to March 2020. The histological and molecular characteristics, progression-free survival (PFS), and overall survival (OS) of the patients were compared. For molecular characteristics, target sequencing was used to determine the H3F3A, HIST1H3B, and TERTp mutations. Results: H3K27M mutations were detected in 12/25 (48.0%) patients. TERTp mutations were not detected in H3K27M-mutant gliomas but were detected in 8/13 (61.5%) of H3 wild-type gliomas. Although it was not significant, H3K27M-mutant gliomas tended to have a shorter PFS (6.7 vs 13.1 months; P = .2928) and OS (22.8 vs 24.4 months; P = .2875) than H3 wild-type gliomas. Moreover, the prognosis of TERTp -mutant gliomas was as poor as that of H3K27M-mutant gliomas. Contrary, 5 gliomas harboring both H3 and TERTp wild-type showed a better median PFS (59.2 vs 6.4 months; P = .0456) and OS (71.8 vs 24.4 months; P = .1168) than those harboring H3K27M or TERTp mutations. Conclusions: TERTp -mutant gliomas included in the H3 wild-type glioma group limited patient survival as they exhibited an aggressive course similar to H3K27M-mutant gliomas. Comprehensive molecular work-up for the H3 wild-type cases may further confirm this finding.