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Rigshospitalet - a part of Copenhagen University Hospital

Targeted next-generation sequencing of adult gliomas for retrospective prognostic evaluation and up-front diagnostics

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  • J K Petersen
  • H B Boldt
  • M D Sørensen
  • S Blach
  • R H Dahlrot
  • S Hansen
  • M Burton
  • M Thomassen
  • T Kruse
  • F R Poulsen
  • L Andreasen
  • H Hager
  • B P Ulhøi
  • S Lukacova
  • G Reifenberger
  • B W Kristensen
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AIMS: We aimed to reclassify a population-based cohort of 529 adult glioma patients to evaluate the prognostic impact of the 2016 World Health Organization (WHO) central nervous system tumour classification. Moreover, we evaluated the feasibility of gene panel next-generation sequencing (NGS) in daily diagnostics of 225 prospective glioma patients.

METHODS: The retrospective cohort was reclassified according to WHO 2016 criteria by immunohistochemistry for IDH-R132H, fluorescence in situ hybridization for 1p/19q-codeletion and gene panel NGS. All tumours of the prospective cohort were subjected to NGS analysis up-front.

RESULTS: The entire population-based cohort was successfully reclassified according to WHO 2016 criteria. NGS results were obtained for 98% of the prospective patients. Survival analyses in the population-based cohort confirmed three major prognostic subgroups, that is, isocitrate dehydrogenase (IDH)-mutant and 1p/19q-codeleted oligodendrogliomas, IDH-mutant astrocytomas and IDH-wildtype glioblastomas. The distinction between WHO grade II and III was prognostic in patients with IDH-mutant astrocytoma. The survival of patients with IDH-wildtype diffuse astrocytomas carrying TERT promoter mutation and/or EGFR amplification overlapped with the poor survival of IDH-wildtype glioblastoma patients.

CONCLUSIONS: Gene panel NGS proved feasible in daily diagnostics. In addition, our study confirms the prognostic role of glioma classification according to WHO 2016 in a large population-based cohort. Molecular features of glioblastoma in IDH-wildtype diffuse glioma were linked to poor survival corresponding to IDH-wildtype glioblastoma patients. The distinction between WHO grade II and III retained prognostic significance in patients with IDH-mutant diffuse astrocytic gliomas.

Original languageEnglish
JournalNeuropathology and Applied Neurobiology
Issue number1
Pages (from-to)108-126
Number of pages19
Publication statusPublished - Feb 2021
Externally publishedYes

Bibliographical note

© 2020 British Neuropathological Society.

    Research areas

  • Adolescent, Adult, Aged, Aged, 80 and over, Astrocytoma/diagnosis, Biomarkers, Tumor/genetics, Brain Neoplasms/diagnosis, Female, Glioblastoma/diagnosis, Glioma/diagnosis, High-Throughput Nucleotide Sequencing, Humans, Isocitrate Dehydrogenase/genetics, Male, Middle Aged, Mutation/genetics, Prognosis, Telomerase/genetics, Young Adult

ID: 71935130