Medical Student University of Missouri School of Medicine Columbia, Missouri, United States
Introduction: Diffuse Astrocytoma (DA) is a well-differentiated (WHO Grade II), slow-growing, diffusely infiltrating intraparenchymal astrocytic neoplasm. Low-grade gliomas cause considerable morbidity, and most will recur after initial therapy. At recurrence, low-grade gliomas can transform into high-grade gliomas (grade III or grade IV), associated with a worse prognosis. Preliminary studies hypothesize that TMZ-induced hypermutation may contribute to malignant transformation, although with highly variable latency. Limited data is available regarding the influence of TMZ hypermutation on overall survival in DA. This study aimed to evaluate the role of TMZ hypermutation and its correlation to overall survival status in patients with DA.
Methods: Using the cBioPortal platform and systematic bioinformatical analysis of the Cancer Genome Atlas Glioma, MSKCC Clinical Cancer Research data for Diffuse Astrocytoma, 116 DA patients were included in this study. Of which 84 were living and 32 were deceased, respectively.
Results: In patients with DA, the TMZ hypermutation status was statistically significant and distinct among the living and deceased populations. Among the deceased patients, 12.5% (4/32) had the TMZ hypermutation versus 1.19% (1/83) of the living patients with the TMZ hypermutation (p-value = 0.03). The 32 deceased patients had a MOS of 69.10 months (95% CI: 51.80-101), (p-value = 0.001). The progression-free status was statically significant among the living and deceased patients. In the living group, 33.3 % (25/75) had a reported progression-free status and 131 median months progression-free (95% CI: 110-NA), compared to 100% (22/22) in the deceased patients with 65.40 median months progression-free (95% CI: 54.10-97.80), (p-value = 0.001).
Conclusion : The findings in this study highlight the impact of TMZ hypermutation on overall survival time in patients with DA. Further studies are needed to evaluate the TMZ hypermutation status to improve treatment options and survival outcomes for DA patients.
