Zusammenfassung
Wie in nur wenigen anderen Bereichen der Onkologie sind in der Neuroonkologie molekulare Marker mittlerweile zu einem wesentlichen Bestandteil von Therapieentscheidungen geworden. Diese Entwicklung wird ermöglicht durch eine rege wissenschaftliche Aktivität zur Erforschung der molekularen Grundlagen von Hirntumoren sowie durch einen hohen prozentualen Einschluss von Hirntumorpatienten in Studien, in denen molekulare Parameter bestimmt und mit klinischer Aussagekraft verknüpft werden. Erste Schritte auf dem Weg zu differenzierten Therapiestrategien sind also beschritten, ihre Umsetzung erfordert Detailkenntnisse und eine intensive Vernetzung zwischen allen an der Behandlung beteiligten Fachdisziplinen.
Abstract
As in only few other areas of oncology, molecular markers in neurooncology have become an integral part of clinical decision-making. This development is driven by a bustling scientific activity exploring the molecular basis and pathogenesis of human brain tumors. In addition, a high percentage of brain tumor patients are included in clinical studies in which molecular markers are assessed and linked with clinical informativeness. First steps towards more differentiated therapeutic strategies against brain tumors have thus been taken. The implementation in the clinical and diagnostic routine requires a detailed knowledge and a close collaboration between all medical disciplines involved.
Literatur
Bettstetter M, Dechant S, Ruemmele P et al (2008) MethyQESD, a robust and fast method for quantitative methylation analyses in HNPCC diagnostics using formalin-fixed and paraffin-embedded tissue samples. Lab Invest 88:1367–1375
Cairncross JG, Ueki K, Zlatescu MC et al (1998) Specific genetic predictors of chemotherapeutic response and survival in patients with anaplastic oligodendrogliomas. J Natl Cancer Inst 90:1473–1479
Cairncross G, Wang M, Shaw E et al (2013) Phase III trial of chemoradiotherapy for anaplastic oligodendroglioma: long-term results of RTOG 9402. J Clin Oncol 31:337–343
Hasselblatt M, Riesmeier B, Lechtape B et al (2011) BRAF-KIAA1549 fusion transcripts are less frequent in pilocytic astrocytomas diagnosed in adults. Neuropathol Appl Neurobiol 37:803–806
Hegi ME, Diserens AC, Gorlia T et al (2005) MGMT gene silencing and benefit from temozolomide in glioblastoma. N Engl J Med 352:997–1003
Horbinski C (2013) To BRAF or not to BRAF: is that even a question anymore? J Neuropathol Exp Neurol 72:2–7
Jones DT, Kocialkowski S, Liu L et al (2008) Tandem duplication producing a novel oncogenic BRAF fusion gene defines the majority of pilocytic astrocytomas. Cancer Res 68:8673–8677
Louis DN, Perry A, Burger P et al (2014) International society of neuropathology-haarlem consensus guidelines for nervous system tumor classification and grading. Brain Pathol 24:429–435
Malmstrom A, Gronberg BH, Marosi C et al (2012) Temozolomide versus standard 6-week radiotherapy versus hypofractionated radiotherapy in patients older than 60 years with glioblastoma: the Nordic randomised, phase 3 trial. Lancet Oncol 13:916–926
Natte R, Van Eijk R, Eilers P et al (2005) Multiplex ligation-dependent probe amplification for the detection of 1p and 19q chromosomal loss in oligodendroglial tumors. Brain Pathol 15:192–197
Nikiforova MN, Hamilton RL (2011) Molecular diagnostics of gliomas. Arch Pathol Lab Med 135:558–568
Northcott PA, Korshunov A, Witt H et al (2011) Medulloblastoma comprises four distinct molecular variants. J Clin Oncol 29:1408–1414
Ogino S, Kawasaki T, Brahmandam M et al (2006) Precision and performance characteristics of bisulfite conversion and real-time PCR (MethyLight) for quantitative DNA methylation analysis. J Mol Diagn 8:209–217
Pfister S, Remke M, Benner A et al (2009) Outcome prediction in pediatric medulloblastoma based on DNA copy-number aberrations of chromosomes 6q and 17q and the MYC and MYCN loci. J Clin Oncol 27:1627–1636
Reifenberger G, Malzkorn B, Acker T et al (2014) Results of the international interlaboratory comparison of MGMT promoter methylation analysis involving twenty-three academic centers in Germany, Austria and the Netherlands. Neuro Oncol 16(Suppl 3):iii49–iii50
Riemenschneider MJ, Hegi ME, Reifenberger G (2010) MGMT promoter methylation in malignant gliomas. Target Oncol 5:161–165
Riemenschneider MJ, Louis DN, Weller M et al (2013) Refined brain tumor diagnostics and stratified therapies: the requirement for a multidisciplinary approach. Acta Neuropathol 126:21–37
Ryan SL, Schwalbe EC, Cole M et al (2012) MYC family amplification and clinical risk-factors interact to predict an extremely poor prognosis in childhood medulloblastoma. Acta Neuropathol 123:501–513
Sampson JH, Heimberger AB, Archer GE et al (2010) Immunologic escape after prolonged progression-free survival with epidermal growth factor receptor variant III peptide vaccination in patients with newly diagnosed glioblastoma. J Clin Oncol 28:4722–4729
Schumacher T, Bunse L, Pusch S et al (2014) A vaccine targeting mutant IDH1 induces antitumour immunity. Nature 512:324–327
Schwartzentruber J, Korshunov A, Liu XY et al (2012) Driver mutations in histone H3.3 and chromatin remodelling genes in paediatric glioblastoma. Nature 482:226–231
Stupp R, Mason WP, Van Den Bent MJ et al (2005) Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med 352:987–996
Sturm D, Witt H, Hovestadt V et al (2012) Hotspot mutations in H3F3A and IDH1 define distinct epigenetic and biological subgroups of glioblastoma. Cancer Cell 22:425–437
Taylor MD, Northcott PA, Korshunov A et al (2012) Molecular subgroups of medulloblastoma: the current consensus. Acta Neuropathol 123:465–472
Turcan S, Rohle D, Goenka A et al (2012) IDH1 mutation is sufficient to establish the glioma hypermethylator phenotype. Nature 483:479–483
Van Den Bent MJ, Brandes AA, Taphoorn MJ et al (2013) Adjuvant procarbazine, lomustine, and vincristine chemotherapy in newly diagnosed anaplastic oligodendroglioma: long-term follow-up of EORTC brain tumor group study 26951. J Clin Oncol 31:344–350
Venneti S, Santi M, Felicella MM et al (2014) A sensitive and specific histopathologic prognostic marker for H3F3A K27M mutant pediatric glioblastomas. Acta Neuropathol 128:743–753
Verhaak RG, Hoadley KA, Purdom E et al (2010) Integrated genomic analysis identifies clinically relevant subtypes of glioblastoma characterized by abnormalities in PDGFRA, IDH1, EGFR, and NF1. Cancer Cell 17:98–110
Vlassenbroeck I, Califice S, Diserens AC et al (2008) Validation of real-time methylation-specific PCR to determine O6-methylguanine-DNA methyltransferase gene promoter methylation in glioma. J Mol Diagn 10:332–337
Weller M, Van Den Bent M, Hopkins K et al (2014) EANO guideline for the diagnosis and treatment of anaplastic gliomas and glioblastoma. Lancet Oncol 15:e395–403
Wick W, Platten M, Meisner C et al (2012) Temozolomide chemotherapy alone versus radiotherapy alone for malignant astrocytoma in the elderly: the NOA-08 randomised, phase 3 trial. Lancet Oncol 13:707–715
Wick W, Meisner C, Hentschel B et al (2013) Prognostic or predictive value of MGMT promoter methylation in gliomas depends on IDH1 mutation. Neurology 81:1515–1522
Wiestler B, Capper D, Holland-Letz T et al (2013) ATRX loss refines the classification of anaplastic gliomas and identifies a subgroup of IDH mutant astrocytic tumors with better prognosis. Acta Neuropathol 126:443–451
Yan H, Parsons DW, Jin G et al (2009) IDH1 and IDH2 mutations in gliomas. N Engl J Med 360:765–773
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Interessenkonflikt
W. Dietmaier, J. Lorenz und M.J. Riemenschneider geben an, dass kein Interessenkonflikt besteht.
Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.
Additional information
Schwerpunktherausgeber
C. Röcken, Kiel
Rights and permissions
About this article
Cite this article
Dietmaier, W., Lorenz, J. & Riemenschneider, M. Molekulare Diagnostik in der Neuropathologie. Pathologe 36, 171–180 (2015). https://doi.org/10.1007/s00292-015-0002-6
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00292-015-0002-6