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IDH mutation status predicted chemoradiation benefit in oligodendroglial tumors
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Patients with oligodendroglial tumors who harbored IDH mutations demonstrated improved outcomes with chemotherapy plus radiation compared with patients with wild-type IDH, according to study results.
Although patients with anaplastic oligodendroglial tumors with 1p/19q codeletion demonstrated improved survival with PCV chemotherapy — consisting of procarbazine (Matulane, Sigma-Tau Pharmaceuticals), lomustine (CeeNu, Corden Pharma) and vincristine — plus radiation in the original analysis of the Radiation Therapy Oncology Group 9402 trial, some patients with non-codeleted tumors also demonstrated benefit, according to background information provided by the researchers.
The investigators thus sought to evaluate other biomarkers associated with outcomes.
They conducted additional analyses on 291 patients. Of them, 210 were evaluated for IDH status. Most of these patients (n=156; 74%) harbored an IDH mutation.
Researchers also evaluated the germline polymorphism rs55705857 associated with IDH in 245 patients, 76 (31%) of whom harbored the G risk allele.
Overall, IDH mutation and G risk allele were associated with improved PFS with chemotherapy plus radiation. Patients harboring IDH mutations who underwent chemotherapy plus radiation also demonstrated longer OS compared with patients who received radiation alone (9.4 years vs. 5.7 years; HR=0.59; 95% CI, 0.4-0.86).
Patients with wild-type IDH who received chemotherapy plus radiation had shorter median OS benefit (1.3 years vs. 1.8 years; HR=1.14; 95% CI, 0.63-2.04) and a lower rate of 10-year survival (6% vs. 4%) than those who received radiation alone.
Chemotherapy plus radiation was associated with improved survival among patients harboring the IDH mutation with codeleted (14.7 years vs. 6.8 years; HR=0.49; 95% CI, 0.28-0.85) and non-codeleted tumors (5.5 years vs. 3.3 years; HR=0.56; 95% CI, 0.32-0.99) compared with radiation alone.
“IDH mutational status identified patients with oligodendroglial tumors who did (and did not) benefit from alkylating-agent chemotherapy with radiation,” the researchers wrote. “Although patients with codeleted tumors lived longest, patients with non-codeleted IDH-mutated tumors also lived longer after chemoradiotherapy.”
Disclosure: See the study for a full list of the researchers’ relevant financial disclosures.
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