James Hamrick, MD, Chairman of the Caris Precision Oncology Alliance, discusses age in risk stratification in patients with mutant isocitrate dehydrogenase (mIDH) glioma.
mIDH is a rare metabolic gene that causes tumor initiation in many gliomas and other cancers. IDH is necessary for the conversion of α-ketoglutarate (α-KG), however, when IDH is mutated it reduces α-KG to oncometabolite D-2-hydroxyglutarate, causing elevated levels. IDH mutations have great impacts on metabolism, cancer biology, and therapeutic sensitivity of gliomas.
A recent study assessed age in the clinical risk stratification of patients with mIDH gliomas. This was done through the evaluation of survival relative to age and molecular data obtained from next-generation sequencing (NGS). Tumors from 598 mIDH gliomas were analyzed and stratified by age at diagnosis into four groups: 12-26 years of age, 27-40 years, 41-60 years, and over 60 years of age. Additionally, patients were sorted into two subtypes, the mIDH astrocytoma group and the mIDH oligodendroglioma group.
For each subtype, comparisons were made between patients ages 27 to 40 years versus 41 to 60 years. Univariate analysis illustrated that patients ages 27 to 40 years had shorter survival in astrocytoma. However, after adjustments for confounding factors, age was not associated with survival. Alternatively, TP53 and TERT-promoter mutations were independently associated with poorer survival in patients with astrocytoma. Age was also not associated with survival in patients with oligodendroglioma. However, KRAS mutations were independently associated with poorer survival in patients with oligodendroglioma.
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