CGCG clinical practice guidelines for the management of adult diffuse gliomas

Jiang, Tao; Nam, Do‐Hyun; Ram, Zvi; Poon, Wai-sang; Wang, Ji‐Guang; Boldbaatar, Damdindorj; Mao, Ying; Ma, Wenbin; Mao, Qing; You, Yongping; Jiang, Chuanlu; Yang, Xuejun; Kang, Chunsheng; Qiu, Xiaoguang; Li, Wenbin; Li, Shaowu; Chen, Ling; Li, Xuejun; Liu, Zhixiong; Wang, Weimin; Bai, Hao; Yu, Yao; Li, Shouwei; Wu, Anhua; Sai, Ke; Li, Guilin; Yao, Kun; Wei, Xinting; Liu, Xianzhi; Zhang, Zhiwen; Dai, Yiwu; Lv, Sheng‐Qing; Wang, Liang; Zhang, Lin; Dong, Jun; Xu, Guohai; Ma, Xiaodong; Zhang, Wei; Zhang, Chuanbao; Chen, Baoshi; You, Guoxiang; Wang, Yongzhi; Wang, Yinyan; Bao, Zhaoshi; Yang, Pei; Fan, Xing; Liu, Xing; Zhao, Zheng; Wang, Zheng; Li, Yiming; Li, Guanzhang; Sun, Fang; Li, Lianwang; Liu, Yanwei; Liu, Shuai; Shan, Xia; Liu, Yuqing; Chai, Rui‐Chao; Hu, Huimin; Chen, Jing; Yan, Wei; Wang, Hongjun; Chen, Lingchao; Yang, Yuan; Wang, Yu; Han, Lei; Wang, Qixue

doi:10.1016/j.canlet.2016.01.024

Cited by 440 publications

(351 citation statements)

References 107 publications

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“…The establishment of a uniform standard is necessary for the measurement of more accurate ADC values. Despite our attempts to minimize differences among treatments by only selecting patients who received standard surgery and concurrent chemoradiation therapy, as described in the CGCG clinical practice guidelines,7 the patients could have been exposed to a variety of other chemotherapies throughout their treatment. In addition, the surgeons were responsible for ensuring that the patients had undergone maximal safe resection, which can lead to selection bias and thereby affect the analysis of the results.…”

Section: Discussionmentioning

confidence: 99%

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The TERT promoter mutation status and MGMT promoter methylation status, combined with dichotomized MRI‐derived and clinical features, predict adult primary glioblastoma survival

et al. 2018

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PurposeThis study aimed to integrate the TERT promoter mutation status, MGMT promoter methylation status, MRI‐derived features, and clinical features into a survival analysis model to better understand adult primary glioblastoma prognosis‐related markers.MethodA total of 304 adult glioblastoma samples collected after surgical resection were selected for retrospective analysis, and Sanger sequencing was performed to detect IDH and TERT promoter mutations. The methylation of the MGMT promoter was analyzed by pyrosequencing, and MRI‐derived and clinical features were dichotomized into easily acquired variables. Random survival forest analysis, Kaplan‐Meier analysis, Cox proportional hazard regression, and LASSO regression were performed for the survival analysis, and ROC analysis and Pearson's chi‐squared test were employed for the correlation analysis.ResultsWild‐type IDH was present in 89.8% of the adult glioblastoma samples, and TERT promoter mutations and MGMT promoter methylation were observed in 66.42% and 38.49% of all adult primary glioblastomas, respectively. Age and MGMT promoter methylation were identified as independent prognostic biomarkers, and the TERT promoter mutation status and MGMT promoter methylation status, when combined with other tumor‐related factors, generated several different survival subgroups. None of the factors investigated in this study predicted the MGMT promoter status, and MRI‐detected necrosis was positively associated with TERT promoter mutations.ConclusionMGMT promoter methylation and TERT promoter mutations, combined with MRI‐derived and clinical features, revealed different survival subgroups with distinct responses to current treatments, and this information increases the ability to predict the survival of adult primary glioblastoma patients. MRI‐detected necrosis often indicates the presence of TERT promoter mutations.

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Section: Discussionmentioning

confidence: 99%

“…A diagram depicting the patient selection process is shown in Figure 1. We selected the included patients based on the stringent criteria defined by the CGCG clinical treatment guidelines 7. Briefly, the selected patients were treated with radiotherapy plus concomitant and adjuvant TMZ chemotherapy after maximal safe resection of the tumor.…”

Section: Methodsmentioning

confidence: 99%

The TERT promoter mutation status and MGMT promoter methylation status, combined with dichotomized MRI‐derived and clinical features, predict adult primary glioblastoma survival

et al. 2018

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“…Temozolomide (TMZ) is an oral chemotherapeutic drug for GBM which penetrates into the brain and damages DNA by the induction of DNA O 6 -methylguanine [4, 7–10]. However, the DNA repair enzyme O 6 -methylguanine methyltransferase (MGMT) could abrogate the cytotoxic O 6 -methylguanine DNA adduct before it causes harm, which may be the important mechanism of TMZ resistance [11, 12].…”

Section: Introductionmentioning

confidence: 99%

GANT61, a GLI inhibitor, sensitizes glioma cells to the temozolomide treatment

Cai

Zhao

et al. 2016

J Exp Clin Cancer Res

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BackgroundThe aim of this study was to investigate the effect of downregulating Hedgehog pathway by GANT61 on human glioma cells, examine the consequent changes of temozolomide (TMZ)-induced effects and explore the molecular mechanisms.MethodsThe cytotoxicity of a Gli1/2 inhibitor, GANT61 was examined both alone and in combination with TMZ in human glioma cell lines. The mRNA and protein expression alterations were determined by quantitative real-time polymerase chain reaction (qRT-PCR) and Western blot, respectively. CCK-8 assay detected the cell proliferative capability. Apoptotic cell number was measured by flow cytometry. The transwell assay was used to test the cell invasive capability. DNA damage effect was identified by COMET assay and γH2AX expression.ResultsProliferation of tumor cells treated with GANT61 in combination with TMZ was significantly suppressed compared with those treated with either drug used alone. The combination treatment induced a higher rate of apoptosis, DNA damage and reduced the invasive capability of glioma cells. DNA damage repair enzyme MGMT and the Notch1 pathway increased in the cells treated by TMZ treatment. However, GANT61 could abrogated the protein increasing.ConclusionsGANT61 sensitizes glioma cells to TMZ treatment by enhancing DNA damage effect, decreasing MGMT expression and the Notch1 pathway.Electronic supplementary materialThe online version of this article (doi:10.1186/s13046-016-0463-3) contains supplementary material, which is available to authorized users.

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“…According to clinical practice guidelines [25, 26], both tumor grade and extent of resection are primary risk factors for therapeutic decision-making. However, it remains unclear whether age is an independent prognostic factor in malignant gliomas, especially in younger adults.…”

Section: Discussionmentioning

confidence: 99%

Radiation combined with temozolomide contraindicated for young adults diagnosed with anaplastic glioma

et al. 2016

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PurposeAge is a major prognostic factor for malignant gliomas. However, few studies have investigated the management of gliomas in young adults. We determined the role of survival and treatment in young adults with advanced gliomas in a large population from the Chinese Glioma Genome Atlas (CGGA).MethodsThis study included 726 adults (age ≥ 18) with histologically proven anaplastic glioma or glioblastoma multiforme (GBM). The overall and progression-free survival was determined in young (age < 50) and older groups (age ≥ 50).ResultsThe study included an older group (OP) of 264 patients and a younger group (YP) of 462patients. In the OP group with GBM and anaplastic glioma, patients treated with RT combined with temozolomide (TMZ) manifested significantly longer OS and PFS compared with patients assigned to RT alone (P < 0.05). In contrast, the YP group diagnosed with anaplastic glioma failed to show any survival advantage with RT plus TMZ compared with RT alone.ConclusionsWe observed no survival benefit in young adults (age < 50) with anaplastic glioma when treated with TMZ combined with RT. Our findings warrant further investigation of younger patients diagnosed with anaplastic glioma treated with radiotherapy plus TMZ chemotherapy.

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CGCG clinical practice guidelines for the management of adult diffuse gliomas

Cited by 440 publications

References 107 publications

The TERT promoter mutation status and MGMT promoter methylation status, combined with dichotomized MRI‐derived and clinical features, predict adult primary glioblastoma survival

The TERT promoter mutation status and MGMT promoter methylation status, combined with dichotomized MRI‐derived and clinical features, predict adult primary glioblastoma survival

GANT61, a GLI inhibitor, sensitizes glioma cells to the temozolomide treatment

Radiation combined with temozolomide contraindicated for young adults diagnosed with anaplastic glioma

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