ArticleNeuro-oncology2017
Cost-effectiveness of IDH testing in diffuse gliomas according to the 2016 WHO classification of tumors of the central nervous system recommendations.
Article in Neuro-oncology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 3 of them syntheses that pooled it.
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Who cites it
39 citing papers in PubMed, 3 syntheses or guidelines pooled it, 71 citations in OpenAlex.
- Global economic differences in modern glioblastoma care - a systematic review.Acta neurochirurgica · 2026Pooled it
- Molecular Biomarker Testing for the Diagnosis of Diffuse Gliomas.Archives of pathology & laboratory medicine · 2022Guideline
- The role of neuropathology in the management of newly diagnosed glioblastoma: a systematic review and evidence-based clinical practice guideline.Journal of neuro-oncology · 2020Pooled it
- Dual Immune Check Point Blockade inJournal of clinical oncology : official journal of the American Society of Clinical Oncology · 2025Trial
- Management of Adult Patients With Isocitrate Dehydrogenase-Mutant Gliomas in Australia: An Expert Position Statement From the Cooperative Trials Group for Neuro-Oncology.Asia-Pacific journal of clinical oncology · 2026Review
- Evaluation of the Idylla IDH1-2 Mutation Assay for the Detection ofInternational journal of molecular sciences · 2026Article
- AI-driven WHO 2021 classification of gliomas based only on H&E-stained slides.Neuro-oncology · 2026Article
- Hybrid classical and quantum computing for enhanced glioma tumor classification using TCGA data.Scientific reports · 2025Article
- The Clinical Role of miRNAs in the Development and Treatment of Glioblastoma.International journal of molecular sciences · 2025Review
- Analysis of the Porphyrin Peak Shift and Fluorescence Lifetime in Gliomas with Different Tumor Grades, Intratumoral Regions, and Visible Fluorescence Status.Diagnostics (Basel, Switzerland) · 2024Article
- Clinical utility of a blood based assay for the detection of IDH1.R132H-mutant gliomas.Nature communications · 2024Article
- A data-centric machine learning approach to improve prediction of glioma grades using low-imbalance TCGA data.Scientific reports · 2024Article
- Cognitive functioning in untreated glioma patients: The limited predictive value of clinical variables.Neuro-oncology · 2024Article
- Article
- Clinical Evaluation of IDH Mutation Status in Formalin-Fixed Paraffin-Embedded Tissue in Gliomas.Molecular diagnosis & therapy · 2023Article
- Artificial-intelligence-based molecular classification of diffuse gliomas using rapid, label-free optical imaging.Nature medicine · 2023Article
- Characterization of an IDH1 R132H Rabbit Monoclonal Antibody, MRQ-67, and Its Applications in the Identification of Diffuse Gliomas.Antibodies (Basel, Switzerland) · 2023Article
- Cost Matrix of Molecular Pathology in Glioma-Towards AI-Driven Rational Molecular Testing and Precision Care for the Future.Biomedicines · 2022Review
- Hierarchical Voting-Based Feature Selection and Ensemble Learning Model Scheme for Glioma Grading with Clinical and Molecular Characteristics.International journal of molecular sciences · 2022Article
- Updates in IDH-Wildtype Glioblastoma.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2022Review
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDue to the decreasing prevalence of IDH1 mutations in older patients, the 2016 World Health Organization (WHO) classification of brain tumors proposed not to perform sequencing for isocitrate dehydrogenase (IDH) in glioblastoma patients ≥55 years old. We present a cost-effectiveness analysis to estimate the financial impact of these guidelines.
methodsFrom 2010 to 2015 we performed 1023 IDH tests in gliomas, amounting to ~$1.09 million in direct laboratory test costs. Samples were tested using R132H-specific immunohistochemistry, DNA sequencing validated for detection of noncanonical IDH1/2 mutations, or both methods.
resultsIn cases tested by DNA sequencing, the fraction of non-R132H mutations was 5.4%, which included only 2 high-grade gliomas in patients ≥55 years (0.9%). When remodeling the optimal age cutoff in our patient population using 5-year age-binning, we found a 10-times higher pretest probability for the presence of a noncanonical IDH1 mutation in the setting of a negative IDH1-R132H immunohistochemistry result in patients <55 years. Applying the independently confirmed age cutoff of 55 years to glioblastoma patients (64%) would result in $403200 saved (43%). By not performing sequencing in patients ≥55 years, the turn-around time to final integrated neuropathological diagnosis is reduced by 53%, allowing these patients to gain earlier benefits from personalized genomic medicine.
conclusionThe negligible prevalence of noncanonical IDH mutations in glioblastoma patients ≥55 years argues against universal IDH sequencing in this population. We predict that adoption of this age-based sequencing cutoff recommendation from the 2016 WHO guidelines will result in significant cost and time savings throughout the global health care system.
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