Accelerated progression after the recurrence of IDH mutant glioma

Backgroundisocric acid dehydrogenase (IDH) mutant glioma is a unique subtype, the 2016 edition of WHO central nervous system tumor classification as a molecular diagnosis as an important part of glioma typeJulie JMiller of the Center for Neurology Neuro-Oncology at Massachusetts General Hospital, USA, analyzed the recurrence and clinical prognosis of IDH mutant gliomas, and the results were published in The Oma-Oncology in May 2019the study methodsthe authors retrospectively analyzed 275 idh mutant glioma patients,used a low-level glioma RANO scale to evaluate the progression of glioma, used the Kaplan-Meier method to calculate survival rates, and analyzed the correlation between survival rates and molecular and histological characteristics and clinical factors (Table 1)Table 1Clinical data on 275 patients with IDH mutant gliomathe results44 (7.6%) patients died and 147 (53.5%) relapsed during the median follow-up period of 6.4 yearsThere was no significant correlation betweenhistopathological classification and the first no progression survival (PFS1)The median PFS1 forII-grade glioma was 4.7 years (95% CI, 4.0-6.1) and the median PFS1 for class III gliomas was 6.7 years (95% CI, 5.3-8.9) (P-0.086)PFS1 inpatients receiving any type of radiotherapy was significantly longer than PFS1 in patients without radiotherapy (median PFS1 7.6 years vs 4.0 years) (P 0.0001) However, there were significant differences in overall rebirth (OS) at level II and III, and os in patients with Grade II tumors were significantly longer (14.4 years; P-0.015) in the first 275 idh mutant gliomas, 147 patients developed tumor progression during follow-up The clinical symptoms of astral glioblastoma and less protoplatic cell tumors were the same as at the time of the initial diagnosis During the 4.1 year of the median follow-up, 79 patients had a second recurrence, with a median interval of 3.1 years (95% CI, 2.1-3.9 years) between the first progression after diagnosis and 5.7 years of the first progression using Cox model analysis, the authors found that the non-progressive rebirth (PFS2) at the time of the second recurrence of the tumor was a potential prognostic marker that could be used to distinguish patients with poor OS conclusion
the interval between the first and second recurrence of idh mutant glioma was 3.1 years, less than 5.7 years from the initial diagnosis to the first recurrence, and showed that idh mutant glioma had an accelerated malignant process therefore, PFS2 can be used as an important indicator to determine the prognosis in future glioma studies.