IDH1 Gene Mutation Defines Brain Tumors That Benefit from Aggressive Surgery; Longer Lifespans Support Molecular Genetics Approach

Astrocytomas are the most common malignant brain tumors. While most patients' tumors prove to be quite aggressive, outcomes overall can vary widely, with some patients surviving for many years. Now a new study has found that malignant astrocytoma patients whose tumors carry a specific genetic mutation benefit greatly from surgical removal of the largest possible amount of tumor. Preliminary results of the study were reported at the 2012 American Society of Clinical Oncology meeting, and the team's full report appears in the January 2014 issue of the journal Neuro-Oncology. A type of glioma, astrocytomas include the highly aggressive glioblastoma and the less aggressive, but still dangerous anaplastic astrocytoma. "We found that the benefit of surgery and how aggressively the surgery should be done depend, in large part, on whether or not patients' tumors have the mutated form of the IDH1 gene," says Daniel Cahill, M.D., Ph.D., of the Pappas Center for Neuro-Oncology in the Massachusetts General Hospital (MGH) Cancer Center, who led the study. "Under the prior system of categorization, these tumors were considered the same diagnosis and were treated the same way; but we have found that this mutation identifies a completely different subclass of glioma that probably should be treated differently." Now an assistant professor of Neurosurgery at Harvard Medical School, Dr. Cahill was at the University of Texas MD Anderson Cancer Center when the study was initiated, and all study participants were treated at MD Anderson. Ian McCutcheon, M.D., professor of Neurosurgery at the MD Anderson Cancer Center, who co-led the study with Dr.
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