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The role of adjuvant chemotherapy in patients with H3K27 altered diffuse midline gliomas: a multicentric retrospective study
Purpose Adult Diffuse midline glioma (DMG) is a very rare disease. DMGs are currently treated with radiotherapy and chemotherapy even if only a few retrospective studies assessed the impact on overall survival (OS) of these approaches. Methods We carried out an Italian multicentric retrospective stu...
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| Published in: | Journal of neuro-oncology 2024-03, Vol.167 (1), p.145-154 |
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| creator | Di Nunno, Vincenzo Lombardi, Giuseppe Simonelli, Matteo Minniti, Giuseppe Mastronuzzi, Angela Di Ruscio, Valentina Corrà, Martina Padovan, Marta Maccari, Marta Caccese, Mario Simonetti, Giorgia Berlendis, Arianna Farinotti, Mariangela Pollo, Bianca Antonelli, Manila Di Muzio, Antonio Dipasquale, Angelo Asioli, Sofia De Biase, Dario Tosoni, Alicia Silvani, Antonio Franceschi, Enrico |
| description | Purpose
Adult Diffuse midline glioma (DMG) is a very rare disease. DMGs are currently treated with radiotherapy and chemotherapy even if only a few retrospective studies assessed the impact on overall survival (OS) of these approaches.
Methods
We carried out an Italian multicentric retrospective study of adult patients with H3K27-altered DMG to assess the effective role of systemic therapy in the treatment landscape of this rare tumor type.
Results
We evaluated 49 patients from 6 Institutions. The median age was 37.3 years (range 20.1–68.3). Most patients received biopsy as primary approach (
n
= 30, 61.2%) and radiation therapy after surgery (
n
= 39, 79.6%). 25 (51.0%) of patients received concurrent chemotherapy and 26 (53.1%) patients received adjuvant temozolomide. In univariate analysis, concurrent chemotherapy did not result in OS improvement while adjuvant temozolomide was associated with longer OS (21.2 vs. 9.0 months, HR 0.14, 0.05–0.41,
p
|
| doi_str_mv | 10.1007/s11060-024-04589-3 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2954777483</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3013915208</sourcerecordid><originalsourceid>FETCH-LOGICAL-c326t-74c226afe0822f859579177d81de04bd51f4ba2c9847a85a144071d4238b54c73</originalsourceid><addsrcrecordid>eNp9kU1vFDEMhiMEokvhD3BAkbhwGXC-1hluqCoUUYlLkbhF2cTTzWo-liTTaiV-PNNuAYkDJx_8-LWth7GXAt4KAHxXhIA1NCB1A9rYtlGP2EoYVA0qVI_ZCsQaG9Pq7yfsWSk7ANCoxFN2oqw2CC2s2M-rLfE89cSnjvu4m2_8WHnY0jDVLWW_P_A08r2vicZa-G2qW36hvkjkvq-UKfKYum4uxIcU-zQSv-7TNPjynns-zH1NYRnMKfBMNU9lT6GmG-KlzvHwnD3pfF_oxUM9Zd8-nl-dXTSXXz99Pvtw2QQl17VBHaRc-47AStlZ0xpsBWK0IhLoTTSi0xsvQ2s1emu80BpQRC2V3RgdUJ2yN8fcfZ5-zFSqG1IJ1Pd-pGkuTrZGI6K2akFf_4PupjmPy3VOgVCtMBLsQskjFZaXSqbO7XMafD44Ae7OjTu6cYsbd-_G3UW_eoieNwPFPyO_ZSyAOgJlaY3XlP_u_k_sLygQmeE</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3013915208</pqid></control><display><type>article</type><title>The role of adjuvant chemotherapy in patients with H3K27 altered diffuse midline gliomas: a multicentric retrospective study</title><source>Springer Link</source><creator>Di Nunno, Vincenzo ; Lombardi, Giuseppe ; Simonelli, Matteo ; Minniti, Giuseppe ; Mastronuzzi, Angela ; Di Ruscio, Valentina ; Corrà, Martina ; Padovan, Marta ; Maccari, Marta ; Caccese, Mario ; Simonetti, Giorgia ; Berlendis, Arianna ; Farinotti, Mariangela ; Pollo, Bianca ; Antonelli, Manila ; Di Muzio, Antonio ; Dipasquale, Angelo ; Asioli, Sofia ; De Biase, Dario ; Tosoni, Alicia ; Silvani, Antonio ; Franceschi, Enrico</creator><creatorcontrib>Di Nunno, Vincenzo ; Lombardi, Giuseppe ; Simonelli, Matteo ; Minniti, Giuseppe ; Mastronuzzi, Angela ; Di Ruscio, Valentina ; Corrà, Martina ; Padovan, Marta ; Maccari, Marta ; Caccese, Mario ; Simonetti, Giorgia ; Berlendis, Arianna ; Farinotti, Mariangela ; Pollo, Bianca ; Antonelli, Manila ; Di Muzio, Antonio ; Dipasquale, Angelo ; Asioli, Sofia ; De Biase, Dario ; Tosoni, Alicia ; Silvani, Antonio ; Franceschi, Enrico</creatorcontrib><description>Purpose
Adult Diffuse midline glioma (DMG) is a very rare disease. DMGs are currently treated with radiotherapy and chemotherapy even if only a few retrospective studies assessed the impact on overall survival (OS) of these approaches.
Methods
We carried out an Italian multicentric retrospective study of adult patients with H3K27-altered DMG to assess the effective role of systemic therapy in the treatment landscape of this rare tumor type.
Results
We evaluated 49 patients from 6 Institutions. The median age was 37.3 years (range 20.1–68.3). Most patients received biopsy as primary approach (
n
= 30, 61.2%) and radiation therapy after surgery (
n
= 39, 79.6%). 25 (51.0%) of patients received concurrent chemotherapy and 26 (53.1%) patients received adjuvant temozolomide. In univariate analysis, concurrent chemotherapy did not result in OS improvement while adjuvant temozolomide was associated with longer OS (21.2 vs. 9.0 months, HR 0.14, 0.05–0.41,
p
< 0.001). Multivariate analysis confirmed the role of adjuvant chemotherapy (HR 0.1, 95%CI: 0.03–0.34,
p
= 0.003). In patients who progressed after radiation and/or chemotherapy the administration of a second-line systemic treatment had a significantly favorable impact on survival (8.0 vs. 3.2 months, HR 0.2, 95%CI 0.1–0.65,
p
= 0.004).
Conclusion
In our series, adjuvant treatment after radiotherapy can be useful in improving OS of patients with H3K27-altered DMG. When feasible another systemic treatment after treatment progression could be proposed.</description><identifier>ISSN: 0167-594X</identifier><identifier>EISSN: 1573-7373</identifier><identifier>DOI: 10.1007/s11060-024-04589-3</identifier><identifier>PMID: 38457090</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Biopsy ; Chemotherapy ; Glioma ; Medicine ; Medicine & Public Health ; Multivariate analysis ; Neurology ; Oncology ; Patients ; Radiation therapy ; Survival ; Temozolomide</subject><ispartof>Journal of neuro-oncology, 2024-03, Vol.167 (1), p.145-154</ispartof><rights>The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c326t-74c226afe0822f859579177d81de04bd51f4ba2c9847a85a144071d4238b54c73</cites><orcidid>0000-0003-4441-9834</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27922,27923</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38457090$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Di Nunno, Vincenzo</creatorcontrib><creatorcontrib>Lombardi, Giuseppe</creatorcontrib><creatorcontrib>Simonelli, Matteo</creatorcontrib><creatorcontrib>Minniti, Giuseppe</creatorcontrib><creatorcontrib>Mastronuzzi, Angela</creatorcontrib><creatorcontrib>Di Ruscio, Valentina</creatorcontrib><creatorcontrib>Corrà, Martina</creatorcontrib><creatorcontrib>Padovan, Marta</creatorcontrib><creatorcontrib>Maccari, Marta</creatorcontrib><creatorcontrib>Caccese, Mario</creatorcontrib><creatorcontrib>Simonetti, Giorgia</creatorcontrib><creatorcontrib>Berlendis, Arianna</creatorcontrib><creatorcontrib>Farinotti, Mariangela</creatorcontrib><creatorcontrib>Pollo, Bianca</creatorcontrib><creatorcontrib>Antonelli, Manila</creatorcontrib><creatorcontrib>Di Muzio, Antonio</creatorcontrib><creatorcontrib>Dipasquale, Angelo</creatorcontrib><creatorcontrib>Asioli, Sofia</creatorcontrib><creatorcontrib>De Biase, Dario</creatorcontrib><creatorcontrib>Tosoni, Alicia</creatorcontrib><creatorcontrib>Silvani, Antonio</creatorcontrib><creatorcontrib>Franceschi, Enrico</creatorcontrib><title>The role of adjuvant chemotherapy in patients with H3K27 altered diffuse midline gliomas: a multicentric retrospective study</title><title>Journal of neuro-oncology</title><addtitle>J Neurooncol</addtitle><addtitle>J Neurooncol</addtitle><description>Purpose
Adult Diffuse midline glioma (DMG) is a very rare disease. DMGs are currently treated with radiotherapy and chemotherapy even if only a few retrospective studies assessed the impact on overall survival (OS) of these approaches.
Methods
We carried out an Italian multicentric retrospective study of adult patients with H3K27-altered DMG to assess the effective role of systemic therapy in the treatment landscape of this rare tumor type.
Results
We evaluated 49 patients from 6 Institutions. The median age was 37.3 years (range 20.1–68.3). Most patients received biopsy as primary approach (
n
= 30, 61.2%) and radiation therapy after surgery (
n
= 39, 79.6%). 25 (51.0%) of patients received concurrent chemotherapy and 26 (53.1%) patients received adjuvant temozolomide. In univariate analysis, concurrent chemotherapy did not result in OS improvement while adjuvant temozolomide was associated with longer OS (21.2 vs. 9.0 months, HR 0.14, 0.05–0.41,
p
< 0.001). Multivariate analysis confirmed the role of adjuvant chemotherapy (HR 0.1, 95%CI: 0.03–0.34,
p
= 0.003). In patients who progressed after radiation and/or chemotherapy the administration of a second-line systemic treatment had a significantly favorable impact on survival (8.0 vs. 3.2 months, HR 0.2, 95%CI 0.1–0.65,
p
= 0.004).
Conclusion
In our series, adjuvant treatment after radiotherapy can be useful in improving OS of patients with H3K27-altered DMG. When feasible another systemic treatment after treatment progression could be proposed.</description><subject>Biopsy</subject><subject>Chemotherapy</subject><subject>Glioma</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Multivariate analysis</subject><subject>Neurology</subject><subject>Oncology</subject><subject>Patients</subject><subject>Radiation therapy</subject><subject>Survival</subject><subject>Temozolomide</subject><issn>0167-594X</issn><issn>1573-7373</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp9kU1vFDEMhiMEokvhD3BAkbhwGXC-1hluqCoUUYlLkbhF2cTTzWo-liTTaiV-PNNuAYkDJx_8-LWth7GXAt4KAHxXhIA1NCB1A9rYtlGP2EoYVA0qVI_ZCsQaG9Pq7yfsWSk7ANCoxFN2oqw2CC2s2M-rLfE89cSnjvu4m2_8WHnY0jDVLWW_P_A08r2vicZa-G2qW36hvkjkvq-UKfKYum4uxIcU-zQSv-7TNPjynns-zH1NYRnMKfBMNU9lT6GmG-KlzvHwnD3pfF_oxUM9Zd8-nl-dXTSXXz99Pvtw2QQl17VBHaRc-47AStlZ0xpsBWK0IhLoTTSi0xsvQ2s1emu80BpQRC2V3RgdUJ2yN8fcfZ5-zFSqG1IJ1Pd-pGkuTrZGI6K2akFf_4PupjmPy3VOgVCtMBLsQskjFZaXSqbO7XMafD44Ae7OjTu6cYsbd-_G3UW_eoieNwPFPyO_ZSyAOgJlaY3XlP_u_k_sLygQmeE</recordid><startdate>20240301</startdate><enddate>20240301</enddate><creator>Di Nunno, Vincenzo</creator><creator>Lombardi, Giuseppe</creator><creator>Simonelli, Matteo</creator><creator>Minniti, Giuseppe</creator><creator>Mastronuzzi, Angela</creator><creator>Di Ruscio, Valentina</creator><creator>Corrà, Martina</creator><creator>Padovan, Marta</creator><creator>Maccari, Marta</creator><creator>Caccese, Mario</creator><creator>Simonetti, Giorgia</creator><creator>Berlendis, Arianna</creator><creator>Farinotti, Mariangela</creator><creator>Pollo, Bianca</creator><creator>Antonelli, Manila</creator><creator>Di Muzio, Antonio</creator><creator>Dipasquale, Angelo</creator><creator>Asioli, Sofia</creator><creator>De Biase, Dario</creator><creator>Tosoni, Alicia</creator><creator>Silvani, Antonio</creator><creator>Franceschi, Enrico</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-4441-9834</orcidid></search><sort><creationdate>20240301</creationdate><title>The role of adjuvant chemotherapy in patients with H3K27 altered diffuse midline gliomas: a multicentric retrospective study</title><author>Di Nunno, Vincenzo ; Lombardi, Giuseppe ; Simonelli, Matteo ; Minniti, Giuseppe ; Mastronuzzi, Angela ; Di Ruscio, Valentina ; Corrà, Martina ; Padovan, Marta ; Maccari, Marta ; Caccese, Mario ; Simonetti, Giorgia ; Berlendis, Arianna ; Farinotti, Mariangela ; Pollo, Bianca ; Antonelli, Manila ; Di Muzio, Antonio ; Dipasquale, Angelo ; Asioli, Sofia ; De Biase, Dario ; Tosoni, Alicia ; Silvani, Antonio ; Franceschi, Enrico</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c326t-74c226afe0822f859579177d81de04bd51f4ba2c9847a85a144071d4238b54c73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Biopsy</topic><topic>Chemotherapy</topic><topic>Glioma</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Multivariate analysis</topic><topic>Neurology</topic><topic>Oncology</topic><topic>Patients</topic><topic>Radiation therapy</topic><topic>Survival</topic><topic>Temozolomide</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Di Nunno, Vincenzo</creatorcontrib><creatorcontrib>Lombardi, Giuseppe</creatorcontrib><creatorcontrib>Simonelli, Matteo</creatorcontrib><creatorcontrib>Minniti, Giuseppe</creatorcontrib><creatorcontrib>Mastronuzzi, Angela</creatorcontrib><creatorcontrib>Di Ruscio, Valentina</creatorcontrib><creatorcontrib>Corrà, Martina</creatorcontrib><creatorcontrib>Padovan, Marta</creatorcontrib><creatorcontrib>Maccari, Marta</creatorcontrib><creatorcontrib>Caccese, Mario</creatorcontrib><creatorcontrib>Simonetti, Giorgia</creatorcontrib><creatorcontrib>Berlendis, Arianna</creatorcontrib><creatorcontrib>Farinotti, Mariangela</creatorcontrib><creatorcontrib>Pollo, Bianca</creatorcontrib><creatorcontrib>Antonelli, Manila</creatorcontrib><creatorcontrib>Di Muzio, Antonio</creatorcontrib><creatorcontrib>Dipasquale, Angelo</creatorcontrib><creatorcontrib>Asioli, Sofia</creatorcontrib><creatorcontrib>De Biase, Dario</creatorcontrib><creatorcontrib>Tosoni, Alicia</creatorcontrib><creatorcontrib>Silvani, Antonio</creatorcontrib><creatorcontrib>Franceschi, Enrico</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of neuro-oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Di Nunno, Vincenzo</au><au>Lombardi, Giuseppe</au><au>Simonelli, Matteo</au><au>Minniti, Giuseppe</au><au>Mastronuzzi, Angela</au><au>Di Ruscio, Valentina</au><au>Corrà, Martina</au><au>Padovan, Marta</au><au>Maccari, Marta</au><au>Caccese, Mario</au><au>Simonetti, Giorgia</au><au>Berlendis, Arianna</au><au>Farinotti, Mariangela</au><au>Pollo, Bianca</au><au>Antonelli, Manila</au><au>Di Muzio, Antonio</au><au>Dipasquale, Angelo</au><au>Asioli, Sofia</au><au>De Biase, Dario</au><au>Tosoni, Alicia</au><au>Silvani, Antonio</au><au>Franceschi, Enrico</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The role of adjuvant chemotherapy in patients with H3K27 altered diffuse midline gliomas: a multicentric retrospective study</atitle><jtitle>Journal of neuro-oncology</jtitle><stitle>J Neurooncol</stitle><addtitle>J Neurooncol</addtitle><date>2024-03-01</date><risdate>2024</risdate><volume>167</volume><issue>1</issue><spage>145</spage><epage>154</epage><pages>145-154</pages><issn>0167-594X</issn><eissn>1573-7373</eissn><abstract>Purpose
Adult Diffuse midline glioma (DMG) is a very rare disease. DMGs are currently treated with radiotherapy and chemotherapy even if only a few retrospective studies assessed the impact on overall survival (OS) of these approaches.
Methods
We carried out an Italian multicentric retrospective study of adult patients with H3K27-altered DMG to assess the effective role of systemic therapy in the treatment landscape of this rare tumor type.
Results
We evaluated 49 patients from 6 Institutions. The median age was 37.3 years (range 20.1–68.3). Most patients received biopsy as primary approach (
n
= 30, 61.2%) and radiation therapy after surgery (
n
= 39, 79.6%). 25 (51.0%) of patients received concurrent chemotherapy and 26 (53.1%) patients received adjuvant temozolomide. In univariate analysis, concurrent chemotherapy did not result in OS improvement while adjuvant temozolomide was associated with longer OS (21.2 vs. 9.0 months, HR 0.14, 0.05–0.41,
p
< 0.001). Multivariate analysis confirmed the role of adjuvant chemotherapy (HR 0.1, 95%CI: 0.03–0.34,
p
= 0.003). In patients who progressed after radiation and/or chemotherapy the administration of a second-line systemic treatment had a significantly favorable impact on survival (8.0 vs. 3.2 months, HR 0.2, 95%CI 0.1–0.65,
p
= 0.004).
Conclusion
In our series, adjuvant treatment after radiotherapy can be useful in improving OS of patients with H3K27-altered DMG. When feasible another systemic treatment after treatment progression could be proposed.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>38457090</pmid><doi>10.1007/s11060-024-04589-3</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0003-4441-9834</orcidid></addata></record> |
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| source | Springer Link |
| subjects | Biopsy Chemotherapy Glioma Medicine Medicine & Public Health Multivariate analysis Neurology Oncology Patients Radiation therapy Survival Temozolomide |
| title | The role of adjuvant chemotherapy in patients with H3K27 altered diffuse midline gliomas: a multicentric retrospective study |
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