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08.03.2024 | Research

The role of adjuvant chemotherapy in patients with H3K27 altered diffuse midline gliomas: a multicentric retrospective study

verfasst von: Vincenzo Di Nunno, Giuseppe Lombardi, Matteo Simonelli, Giuseppe Minniti, Angela Mastronuzzi, Valentina Di Ruscio, Martina Corrà, Marta Padovan, Marta Maccari, Mario Caccese, Giorgia Simonetti, Arianna Berlendis, Mariangela Farinotti, Bianca Pollo, Manila Antonelli, Antonio Di Muzio, Angelo Dipasquale, Sofia Asioli, Dario De Biase, Alicia Tosoni, Antonio Silvani, Enrico Franceschi

Erschienen in: Journal of Neuro-Oncology | Ausgabe 1/2024

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Abstract

Purpose

Adult Diffuse midline glioma (DMG) is a very rare disease. DMGs are currently treated with radiotherapy and chemotherapy even if only a few retrospective studies assessed the impact on overall survival (OS) of these approaches.

Methods

We carried out an Italian multicentric retrospective study of adult patients with H3K27-altered DMG to assess the effective role of systemic therapy in the treatment landscape of this rare tumor type.

Results

We evaluated 49 patients from 6 Institutions. The median age was 37.3 years (range 20.1–68.3). Most patients received biopsy as primary approach (n = 30, 61.2%) and radiation therapy after surgery (n = 39, 79.6%). 25 (51.0%) of patients received concurrent chemotherapy and 26 (53.1%) patients received adjuvant temozolomide. In univariate analysis, concurrent chemotherapy did not result in OS improvement while adjuvant temozolomide was associated with longer OS (21.2 vs. 9.0 months, HR 0.14, 0.05–0.41, p < 0.001). Multivariate analysis confirmed the role of adjuvant chemotherapy (HR 0.1, 95%CI: 0.03–0.34, p = 0.003). In patients who progressed after radiation and/or chemotherapy the administration of a second-line systemic treatment had a significantly favorable impact on survival (8.0 vs. 3.2 months, HR 0.2, 95%CI 0.1–0.65, p = 0.004).

Conclusion

In our series, adjuvant treatment after radiotherapy can be useful in improving OS of patients with H3K27-altered DMG. When feasible another systemic treatment after treatment progression could be proposed.

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Titel: The role of adjuvant chemotherapy in patients with H3K27 altered diffuse midline gliomas: a multicentric retrospective study
verfasst von: Vincenzo Di Nunno
Giuseppe Lombardi
Matteo Simonelli
Giuseppe Minniti
Angela Mastronuzzi
Valentina Di Ruscio
Martina Corrà
Marta Padovan
Marta Maccari
Mario Caccese
Giorgia Simonetti
Arianna Berlendis
Mariangela Farinotti
Bianca Pollo
Manila Antonelli
Antonio Di Muzio
Angelo Dipasquale
Sofia Asioli
Dario De Biase
Alicia Tosoni
Antonio Silvani
Enrico Franceschi
Publikationsdatum: 08.03.2024
Verlag: Springer US
Erschienen in: Journal of Neuro-Oncology / Ausgabe 1/2024
Print ISSN: 0167-594X
Elektronische ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-024-04589-3

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