|
|
NCCTG 94-72-53: Diagnostic and
prognostic significance of 1p and 19q deletions in patients (pts) with
low-grade oligodendroglioma and astrocytoma
J. C. Buckner, K. V. Ballman, B. W.
Scheithauer, R. M. Arusell, H. E. Blair, S. M. Passe, P. D. Brown, K.
A. Jaeckle, E. G. Shaw, R. B. Jenkins
Mayo Clinic, Rochester, MN;
Meritcare CCOP, Fargo, ND; Mayo Clinic, Jacksonville, FL; Wake Forest
Univ, Winston-Salem, NC
Background. Tumor
deletions of chromosomes 1p and 19q are associated with improved
prognosis and responsiveness to chemotherapy in pts with anaplastic
oligodendroglioma.
Their significance in those with low-grade
gliomas has not been established.
Methods.
Paraffin-embedded tumor tissue was obtained from 134 pts enrolled in
two trials for newly-diagnosed low-grade glioma: 86-72-51, a phase III
trial of 50.4 Gy vs 64.8 Gy (Shaw et al: JCO 2002;20:2267-76), and
93-72-02, a phase II trial of PCV for 6 cycles followed by radiation
therapy (Buckner et al: JCO 21:251-255, 2003).
1p and 19q deletions were determined by
FISH.
Kaplan-Meier distributions of overall
survival (OS) and progression-free survival (PFS) for pts whose tumors
did or did not exhibit both 1p and 19q deletions were compared using
the Wilcoxon test.
Results. Of 134 pts, FISH
was informative for 100.
The frequency of 1p and 19q deletions by
tumor histology, as well as 5-year and median OS and PFS are provided
below.
Conclusions. Low-grade
O/OA pts have a frequency of 1p/19q deletions similar to those with
anaplastic O/OA.
1p and 19q deletions are associated with
superior 5-year as well as median OS and PFS in low-grade O/OA
pts.
FISH assessment of 1p and 19q status may
assist in counseling O/OA pts regarding prognosis and treatment
options.
|
Oligo(O)
|
Mixed OligoAstro (OA)
|
Astro
|
Total
|
|
FREQUENCIES
|
|
|
|
|
|
TOTAL
|
48
|
30
|
22
|
100
|
|
1P- & 19Q-
|
27 (56%)
|
10 (33%)
|
1 (5%)
|
38 (38%)
|
|
Not 1P- & 19Q-
|
21 (44%)
|
20 (67%)
|
21 (95%)
|
62 (62%)
|
|
OS BY 1P & 19Q
STATUS
|
|
|
|
|
|
5-year
|
|
|
|
|
|
Deleted
|
96%
|
90%
|
100%
|
95%
|
|
Not deleted
|
71%
|
60%
|
62%
|
65%
|
|
median (mos.)
|
|
|
|
|
|
Deleted
|
156
|
140
|
NR
|
151
|
|
Not deleted
|
133
|
87
|
NR
|
129
|
|
p-value*
|
|
|
|
0.02 (O/OA only)
|
|
p-value*
|
|
|
|
0.023 (All)
|
|
PFS by 1P & 19Q
STATUS
|
|
|
|
|
|
5-year
|
|
|
|
|
|
Deleted
|
80%
|
78%
|
100%
|
80%
|
|
Not deleted
|
66%
|
36%
|
41%
|
47%
|
|
Median (mos.)
|
|
|
|
|
|
Deleted
|
96
|
97
|
NR
|
98
|
|
Not deleted
|
84
|
40
|
32
|
42
|
|
p-value*
|
|
|
|
0.04 (O/OA only)
|
|
p-value*
|
|
|
|
0.018 (All)
|
|
NR = not reached; *Wilcoxon
test
|
|
