Evidence map›Paper›PMID 27571885›Full record

Trial reportNeuro-oncology2017

Chemotherapy for adult low-grade gliomas: clinical outcomes by molecular subtype in a phase II study of adjuvant temozolomide.

Michael Wahl, Joanna J Phillips, Annette M Molinaro, Yi Lin, Arie Perry, Daphne A Haas-Kogan, Joseph F Costello, Manisha Dayal, Nicholas Butowski, Jennifer L Clarke and 4 more

Abstract readClinical Trial, Phase II
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Neuro-oncology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 61 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
61citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

61 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. SEOM clinical guideline of diagnosis and management of low-grade glioma (2017).Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2018
    Guideline
  4. Trial
  5. Trial
  6. Review
  7. Article
  8. Review
  9. Review
  10. Article
  11. Review
  12. Article
  13. Article
  14. Benign Glioma.Advances in experimental medicine and biology · 2023
    Article
  15. Article
  16. Review
  17. Review
  18. Isocitrate Dehydrogenase Mutant Grade II and III Glial Neoplasms.Hematology/oncology clinics of North America · 2022
    Review
  19. Article
  20. Article

1 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors.

Michael WahlDepartment of Radiation Oncology, University of California, San Francisco, USA.
Joanna J PhillipsDepartment of Pathology, University of California, San Francisco, USA.
Annette M MolinaroDepartment of Neurosurgery, University of California, San Francisco, USA.
Yi LinDepartment of Neurosurgery, University of California, San Francisco, USA.
Arie PerryDepartment of Pathology, University of California, San Francisco, USA.
Daphne A Haas-KoganDepartment of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Joseph F CostelloDepartment of Neurosurgery, University of California, San Francisco, USA.
Manisha DayalDepartment of Radiology and Biomedical Imaging, University of California, San Francisco, USA.
Nicholas ButowskiDepartment of Neurosurgery, University of California, San Francisco, USA.
Jennifer L ClarkeDepartment of Neurosurgery, University of California, San Francisco, USA.
Michael PradosDepartment of Neurosurgery, University of California, San Francisco, USA.
Sarah NelsonDepartment of Radiology and Biomedical Imaging, University of California, San Francisco, USA.
Mitchel S BergerDepartment of Neurosurgery, University of California, San Francisco, USA.
Susan M ChangDepartment of Neurosurgery, University of California, San Francisco, USA.

Funding

Tissue CoreP50CA097257 · NCI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Susan M Chang · 2002 to 2026
$57.4M
Imaging Guided Genomics of Malignant TransformationR01CA169316 · NCI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI COSTELLO, JOSEPH F · 2013 to 2017
$3.0M
NCI NIH HHS P50 CA097257NCI NIH HHS R01 CA169316
6 · The paper itself

Abstract

Background: Optimal adjuvant management of adult low-grade gliomas is controversial. Recently described tumor classification based on molecular subtype has the potential to individualize adjuvant therapy but has not yet been evaluated as part of a prospective trial. Methods: Patients aged 18 or older with newly diagnosed World Health Organization grade II low-grade gliomas and gross residual disease after surgical resection were enrolled in the study. Patients received monthly cycles of temozolomide for up to 1 year or until disease progression. For patients with available tissue, molecular subtype was assessed based upon 1p/19q codeletion and isocitrate dehydrogenase-1 R132H mutation status. The primary outcome was radiographic response rate; secondary outcomes included progression-free survival (PFS) and overall survival (OS). Results: One hundred twenty patients were enrolled with median follow-up of 7.5 years. Overall response rate was 6%, with median PFS and OS of 4.2 and 9.7 years, respectively. Molecular subtype was associated with rate of disease progression during treatment (P<.001), PFS (P=.007), and OS (P<.001). Patients with 1p/19q codeletion demonstrated a 0% risk of progression during treatment. In an exploratory analysis, pretreatment lesion volume was associated with both PFS (P<.001) and OS (P<.001). Conclusions: While our study failed to meet the primary endpoint for objective radiographic response, patients with high-risk low-grade glioma receiving adjuvant temozolomide demonstrated a high rate of radiographic stability and favorable survival outcomes while meaningfully delaying radiotherapy. Patients with 1p/19q codeletion are potential candidates for omission of adjuvant radiotherapy, but further work is needed to directly compare chemotherapy with combined modality therapy.

Indexed as

AdultAgedAntineoplastic Agents, AlkylatingBrain NeoplasmsChemotherapy, AdjuvantDacarbazineDisease ProgressionFemaleFollow-Up StudiesGliomaHumansIsocitrate DehydrogenaseMaleMiddle AgedMutationNeoplasm GradingAntineoplastic Agents, AlkylatingDacarbazineIsocitrate DehydrogenaseTemozolomideclinical trialslow-grade gliomamolecular markers

Identifiers

PMID27571885
PMCPMC5464133

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.