Molecular genetics of oligodendrogliomas: a model for improved clinical management in the field of neurooncology.
Over the last several years, oligodendroglial tumors have become a model for the positive role of molecular genetics in improved treatment of patients with brain tumors. Oligodendrogliomas, in contrast to astrocytic gliomas, frequently respond to chemotherapy and have a better overall prognosis. Combined loss of chromosomes 1p and 19q has proven to be a powerful predictor of chemotherapeutic response and survival in oligodendrogliomas. In contrast, other genetic alterations, such as TP53 and PTEN mutations, EGFR amplification, and homozygous deletion of CDKN2A have been correlated with worse outcome in these tumors. Furthermore, 1p/19q loss has been shown to correlate with unequivocal oligodendroglial tumor histology, location and growth pattern of tumors within the brain, and magnetic resonance imaging characteristics. Although much is also known about the molecular pathological characteristics of astrocytic gliomas, the significance of this information to clinical management in patients with these tumors has not been as striking as has been the case for oligodendrogliomas; possible reasons for this are discussed. In this paper the author will summarize these advances, thus attempting to highlight the molecular genetic study of oligodendrogliomas as a model for improved clinical management in the field of neurooncology.
Nutt
Catherine L
CL
Department of Pathology, Neurosurgical Service and Cancer Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA. cnutt@partners.org
D001932:Brain Neoplasms / Q000175:diagnosis / Q000235:genetics*; D019468:Disease Management; D006801:Humans; D008495:Medical Oncology / Q000379:methods; D008957:Models, Genetic; D008967:Molecular Biology / Q000379:methods*; D009837:Oligodendroglioma / Q000175:diagnosis / Q000235:genetics*