title: A simplified approach for molecular classification of glioblastomas (GBMs): experience from a tertiary care center in India.
abstract: This study aims to establish a simplified molecular classification of glioblastomas (GBMs) based on molecular genetic alterations. GBM cases (n-114) were evaluated for IDH-1 and TP53 mutation by Sanger sequencing, PDGFRA and EGFR amplification by FISH, NF1 and YKL40 expression by qRT-PCR. Subsequently they were classified into four subgroups: classical like (CL), proneural like (PN), mesenchymal like (MES) and neural like (NEU). CL subtype was most frequent (39 %), followed by PN (32 %) and MES (20 %) subtypes. PN subtype had significantly younger age at presentation and longest survival (median PFS-82.5 weeks; 1 and 2 years OS-90.6 and 71.3 %). Other three subgroups had equally poor prognosis and hence, clubbed together as non-proneural (Non-PN) (median PFS-39 weeks; 1 and 2 years OS-66 and 0 %). Hence, we recommended this relatively easy method of subclassifying GBMs into PN and Non-PN which are statistically different in prognosis (both OS and PFS on uni and multivariate analysis). Although evaluation of six molecular alterations for identifying these two subgroups is still cumbersome, we propose segregation of PN subtype alone based on assessment of IDH1, TP53 and PDGFRA status, which is relatively easy and may be amenable to routine practice.
authors: Department of Pathology, All India Institute of Medical Sciences (AIIMS), New Delhi, 110029, India.
authors: Suvendu
authors: S
authors: Purkait
authors: Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India.
authors: Supriya
authors: S
authors: Mallick
authors: Department of Pathology, All India Institute of Medical Sciences (AIIMS), New Delhi, 110029, India.
authors: Vikas
authors: V
authors: Sharma
authors: Department of Pathology, All India Institute of Medical Sciences (AIIMS), New Delhi, 110029, India.
authors: Anupam
authors: A
authors: Kumar
authors: Department of Pathology, All India Institute of Medical Sciences (AIIMS), New Delhi, 110029, India.
authors: Pankaj
authors: P
authors: Pathak
authors: Department of Pathology, All India Institute of Medical Sciences (AIIMS), New Delhi, 110029, India.
authors: Prerana
authors: P
authors: Jha
authors: Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India.
authors: Ahitagni
authors: A
authors: Biswas
authors: Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India.
authors: Pramod Kumar
authors: PK
authors: Julka
authors: Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
authors: Deepak
authors: D
authors: Gupta
authors: Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
authors: Ashish
authors: A
authors: Suri
authors: Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India.
authors: Ashish Datt
authors: AD
authors: Upadhyay
authors: Department of Pathology, All India Institute of Medical Sciences (AIIMS), New Delhi, 110029, India.
authors: Vaishali
authors: V
authors: Suri
authors: Department of Pathology, All India Institute of Medical Sciences (AIIMS), New Delhi, 110029, India.
authors: Mehar C
authors: MC
authors: Sharma
authors: Department of Pathology, All India Institute of Medical Sciences (AIIMS), New Delhi, 110029, India. sarkar.chitra@gmail.com.
authors: Chitra
authors: C
authors: Sarkar
mesh_terms: D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000145:classification* / Q000235:genetics*; D004252:DNA Mutational Analysis; D066246:ErbB Receptors / Q000235:genetics; D005260:Female; D005909:Glioblastoma / Q000145:classification* / Q000235:genetics*; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D007194:India; D007521:Isocitrate Dehydrogenase / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D009154:Mutation; D021141:Nucleic Acid Amplification Techniques / Q000379:methods; D020796:Receptor, Platelet-Derived Growth Factor alpha / Q000235:genetics; D017422:Sequence Analysis, DNA / Q000379:methods; D062606:Tertiary Care Centers; D016159:Tumor Suppressor Protein p53 / Q000235:genetics*; D055815:Young Adult
chemical_list: C495901:TP53 protein, human; D016159:Tumor Suppressor Protein p53; D007521:Isocitrate Dehydrogenase; C543588:IDH1 protein, human; C512478:EGFR protein, human; D066246:ErbB Receptors; D020796:Receptor, Platelet-Derived Growth Factor alpha
keywords: Glioblastoma; Molecular classification; Non-Proneural; Proneural