@article{c7b202ce406d473fae533a75133cd8a6,
title = "Salvage therapies for radiation-relapsed isocitrate dehydrogenase-mutant astrocytoma and 1p/19q codeleted oligodendroglioma",
abstract = "Background. Optimal management for recurrent IDH-mutant glioma after radiation therapy (RT) is not well-defined. This study assesses practice patterns for managing recurrent IDH-mutant astrocytoma (Astro) and 1p/19q codeleted oligodendroglioma (Oligo) after RT and surveys their clinical outcomes after different salvage approaches. Methods. Ninety-four recurrent Astro or Oligo patients after RT who received salvage systemic therapy (SST) between 2001 and 2019 at a tertiary cancer center were retrospectively analyzed. SST was defined as either alkylating chemotherapy (AC) or nonalkylating therapy (non-AC). Overall survival (OS) and progression-free survival (PFS) were calculated using the Kaplan-Meier method from the start of SST. Multivariable analysis (MVA) was conducted using Cox regression analysis. Results. Recurrent Oligo (n = 35) had significantly higher PFS (median: 3.1 vs 0.8 years, respectively, P = .002) and OS (median: 6.3 vs 1.5 years, respectively, P < .001) than Astro (n = 59). Overall, 90% of recurrences were local. Eight-three percent received AC as the first-line SST; 50% received salvage surgery before SST; approximately 50% with local failure >2 years after prior RT received reirradiation. On MVA, non-AC was associated with worse OS for both Oligo and Astro; salvage surgery was associated with improved PFS and OS for Astro; early reirradiation was associated with improved PFS for Astro. Conclusions. Recurrent radiation-relapsed IDH-mutant gliomas represent a heterogeneous group with variable treatment approaches. Surgery, AC, and reirradiation remain the mainstay of salvage options for retreatment.",
keywords = "Chemotherapy, IDH-mutant glioma, recurrence, reirradiation, salvage therapy, surgery",
author = "Sirui Ma and Soumon Rudra and Campian, {Jian L.} and Chheda, {Milan G.} and Johanns, {Tanner M.} and George Ansstas and Abraham, {Christopher D.} and Chicoine, {Michael R.} and Leuthardt, {Eric C.} and Dowling, {Joshua L.} and Dunn, {Gavin P.} and Kim, {Albert H.} and Jiayi Huang",
note = "Funding Information: Conflict of interest statement. J.H. reports research support from Pfizer, outside the submitted work. J.L.C. reports research support from NeoImmuneTech Inc., Incyte Corporation, and Merck, outside the submitted work. The laboratory of M.G.C. has received funding support from NeoimmuneTech Inc. and M.G.C. receives royalties from UpToDate, outside the submitted work. M.G.C. has received research support from Orbus Pharmaceuticals for a clinical trial for patients with anaplastic oligodendrogliomas, outside the submitted work. G.P.D. is a cofounder of Immunovalent and a member of the Scientific Advisory Board for Ziopharm Oncology, outside the submitted work. A.H.K. is a consultant for Monteris Medical and received research grants from Monteris Medical, Stryker, and Collagen Matrix, outside the submitted work. M.R.C. reports funding from IMRIS Inc. for an unrestricted educational grant to support an iMRI database and outcomes analysis project, the IMRIS Muliticenter intraoperative MRI Neurosurgery Database (I-MiND), The Head for the Cure Foundation, Mrs. Carol Rossfeld and The Alex & Alice Aboussie Family Charitable Foundation, an unrestricted educational grant from the Subcortical Surgery Grant Program, and research support from Barbara and George Holtzman, outside the submitted work. E.C.L. reports stock ownership: Neurolutions, General Sensing, Osteovantage, Pear Therapeutics, Face to Face Biometrics, Immunovalent, Caeli Vascular, Acera, Sora Imaging Solutions, Inner Cosmos; consultant for Monteris Medical, E15, Acera, Alcyone, Intellectual Ventures, Medtronic Inc., Neurolutions, Osteovantage, Pear Therapeutics, Inc., Sante Ventures, and Microbot; Scientific Advisory Board for Pear Therapeutics, Microbot; licensing from Intellectual Property: Neurolutions, Osteovantage, Caeli Vascular; and licensing/product development agreements or royalties for inventions/IP: Cerovations, Intellectual Ventures, outside the submitted work. The remaining authors declare no conflict of interest. Publisher Copyright: {\textcopyright} The Author(s) 2021.",
year = "2021",
month = jan,
day = "1",
doi = "10.1093/noajnl/vdab081",
language = "English",
volume = "3",
journal = "Neuro-Oncology Advances",
issn = "2632-2498",
number = "1",
}