Evidence map›Paper›PMID 42747321›Full record

ArticleNeuro-oncology2026

High-grade astrocytoma with piloid features: A clinical and genomic analysis of prognostic factors using a large cohort.

Shuodan Zhang, Omkar Singh, Karen Dazelle, Martha Quezado, Patrick J Cimino, Zied Abdullaev, Jing Wu, Calixto-Hope Lucas, Karisa C Schreck, Matthias Holdhoff and 72 more

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Article in Neuro-oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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5 · Who and what money

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82 authors.

Shuodan ZhangCenter for Cancer Research, National Cancer Institute, Bethesda, Maryland, USA.ORCID 0009-0003-0525-5600
Omkar SinghCenter for Cancer Research, National Cancer Institute, Bethesda, Maryland, USA.ORCID 0000-0002-4500-7519
Karen DazelleCenter for Cancer Research, National Cancer Institute, Bethesda, Maryland, USA.ORCID 0009-0006-1357-2384
Martha QuezadoCenter for Cancer Research, National Cancer Institute, Bethesda, Maryland, USA.ORCID 0009-0004-0941-8662
Patrick J CiminoCenter for Cancer Research, National Cancer Institute, Bethesda, Maryland, USA.ORCID 0000-0003-0441-4502
Zied AbdullaevCenter for Cancer Research, National Cancer Institute, Bethesda, Maryland, USA.ORCID 0000-0001-6345-2088
Jing WuCenter for Cancer Research, National Cancer Institute, Bethesda, Maryland, USA.ORCID 0000-0002-1686-9646
Calixto-Hope LucasDepartment of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.ORCID 0000-0002-8347-9592
Karisa C SchreckDepartment of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.ORCID 0000-0001-7181-3269
Matthias HoldhoffSidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland, USA.ORCID 0000-0002-3285-3484
Peter PytelDepartment of Pathology, The University of Chicago, Chicago, Illinois, USA.ORCID 0000-0001-9506-4709
Vanessa GoodwillDepartment of Pathology, University of California San Diego, San Diego, California, USA.ORCID 0000-0001-7665-7146
Rob MacaulayMoffitt Cancer Center, Tampa, Florida, USA.ORCID 0000-0003-1115-3654
William McDonaldAllina Health, Minneapolis, Minnesota, USA.ORCID 0000-0002-7702-9309
Roberta SeidmanDepartment of Pathology, Stony Brook University School of Medicine, Stony Brook, New York, USA.ORCID 0000-0002-2768-6933
Matthew WoodDepartment of Pathology and Laboratory Medicine, Oregon Health and Science University, Portland, Oregon, USA.ORCID 0000-0002-2385-8128
Krishna BharaniDepartment of Pathology, Stanford University, Stanford, California, USA.ORCID 0000-0002-5441-4423
Janna NeltnerDepartment of Pathology, University of Kentucky, Lexington, Kentucky, USA.ORCID 0000-0002-2843-0411
Hope RichardDepartment of Pathology, Virginia Commonwealth University, Richmond, Virginia, USA.
Koping ChangNational Taiwan University Hospital, Taipei, Taiwan.ORCID 0000-0001-7873-3640
Linda SzymanskiHackensack University Medical Center, Hackensack, New Jersey, USA.
Stephen YipVancouver General Hospital, Vancouver, British Columbia, Canada.ORCID 0000-0002-8514-9861
Abir MukherjeeHealth Network Laboratories, Allentown, Pennsylvania, USA.
Osorio Lopes Abath NetoDepartment of Pathology, University of Iowa, Iowa City, Iowa, USA.ORCID 0000-0003-2787-5483
Suash J SharmaMedical College of Georgia, Augusta University, Augusta, Georgia, USA.ORCID 0000-0001-9028-1771
Richard GreenKaiser Permanente Los Angeles, Los Angeles, California, USA.ORCID 0009-0006-1276-0535
Daniel BrownCellNetix Pathology and Laboratory, Seattle, Washington, USA.
Maria A GubbiottiThe University of Texas MD Anderson Cancer Center, Houston, Texas, USA.ORCID 0000-0003-2246-7958
Leomar Y BallesterThe University of Texas MD Anderson Cancer Center, Houston, Texas, USA.ORCID 0000-0002-6854-6830
Jennifer EschbacherBarrow Neurological Institute, Phoenix, Arizona, USA.
Matthew Smith-CohnBarrow Neurological Institute, Phoenix, Arizona, USA.ORCID 0000-0002-9102-0802
Murat GokdenDepartment of Pathology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
Cristina VincentelliMount Sinai Medical Center, Miami Beach, Florida, USA.ORCID 0000-0002-6541-9588
William YongUniversity of California Irvine Medical Center, Irvine, California, USA.ORCID 0000-0002-0879-0209
Julieann LeeSt. Jude Children's Hospital, Memphis, Tennessee, USA.
Christopher MountMassachusetts General Hospital, Boston, Massachusetts, USA.ORCID 0000-0003-1635-2492
Joseph FulmerBeaumont Hospital, Royal Oak, Michigan, USA.
Michael SunBrigham and Women's Hospital, Boston, Massachusetts, USA.ORCID 0009-0006-1159-5750
Keith LigonBrigham and Women's Hospital, Boston, Massachusetts, USA.ORCID 0000-0002-7733-600X
Mariarita SantiChildren's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.ORCID 0000-0002-6728-3450
Emily Ling-Lin PaiChildren's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.ORCID 0000-0002-6967-5239
Gabrielle YeaneyCleveland Clinic, Cleveland, Ohio, USA.ORCID 0000-0002-9374-1435
Sanda AlexandrescuBoston Children's Hospital, Boston, Massachusetts, USA.ORCID 0000-0001-9246-4184
Ravi RaghavanLoma Linda University Medical Center, Loma Linda, California, USA.
Igor FernandesLaboratorio Bacchi, Sao Paulo, Brazil.ORCID 0000-0003-0377-0441
Gerald Feliz ReisJoe DeMaggio Children's Hospital/Memorial Regional Hospital, Hollywood, Florida, USA.ORCID 0009-0003-3674-2145
Jacob MandelBaylor College of Medicine, Houston, Texas, USA.ORCID 0000-0001-5916-5668
Dario CaccamoMercy General Hospital, Sacramento, California, USA.
Shilpa RaoNational Institute of Mental Health and Neurosciences, Bangalore, India.
Omar H ButtWashington University School of Medicine, St. Louis, Missouri, USA.ORCID 0000-0003-2252-3673
Sonika DahiyaWashington University School of Medicine, St. Louis, Missouri, USA.ORCID 0000-0002-5585-0964
Sara StoneDepartment of Pathology, University of Michigan, Ann Arbor, Michigan, USA.ORCID 0000-0002-1689-8148
Kyle ConwayDepartment of Pathology, University of Michigan, Ann Arbor, Michigan, USA.ORCID 0000-0002-3888-5583
MacLean P NasrallahHospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.ORCID 0000-0003-4861-0898
Christine FullerDepartment of Pathology, SUNY Upstate Medical University, Syracuse, New York, USA.ORCID 0000-0001-7919-7675
Angus TolandDepartment of Pathology, University of Colorado, Aurora, Colorado, USA.ORCID 0000-0003-4453-7101
Rimas V LukasDepartment of Neurology, Northwestern University, Chicago, Illinois, USA.ORCID 0000-0002-9352-5396
David CachiaDepartment of Medicine-Division of Hematology/Oncology, University of Massachusetts Memorial Health, Worcester, Massachusetts, USA.ORCID 0000-0002-5860-8452
Erik J UhlmannBeth Israel Deaconess Medical Center, Boston, Massachusetts, USA.ORCID 0000-0003-1432-4754
Matthew McCordDepartment of Pathology, University of Virginia, Charlottesville, Virginia, USA.ORCID 0000-0001-7673-4463
Jeffrey HelgagerDepartment of Pathology and Laboratory Medicine, University of Wisconsin, Madison, Wisconsin, USA.ORCID 0000-0002-5250-6500
Karam HanDepartment of Pathology and Laboratory Medicine, University of Wisconsin, Madison, Wisconsin, USA.ORCID 0009-0002-7735-0925
Arie PerryDepartment of Pathology, University of California, San Francisco, San Francisco, California, USA.ORCID 0000-0002-8300-7261
Sandra PerezDepartment of Pathology, University of California, San Francisco, San Francisco, California, USA.ORCID 0009-0006-6492-8619
Elena DaoudUniversity of Texas Southwestern Medical Center, Dallas, Texas, USA.ORCID 0000-0001-8840-5106
Darby BeDellDepartment of Pathology, University of Minnesota, Minneapolis, Minnesota, USA.ORCID 0009-0002-3758-7370
Hilary HighfieldNorton Neuroscience Institute, Louisville, Kentucky, USA.ORCID 0009-0007-7808-1698
Peter KobalkaDepartment of Pathology, The Ohio State University, Columbus, Ohio, USA.
James Stephen NixAlice L. Walton School of Medicine, Bentonville, Arkansas, USA.ORCID 0000-0001-5386-3617
Edjah NduomDepartment of Neurosurgery, Emory University, Atlanta, Georgia, USA.ORCID 0000-0002-6323-7799
Stewart NeillDepartment of Neurosurgery, Emory University, Atlanta, Georgia, USA.ORCID 0000-0003-3031-9242
Mark R GilbertFred Hutchinson Cancer Center, Seattle, Washington, USA.ORCID 0000-0003-2556-9722
Nelli LakisDepartment of Pathology and Laboratory Medicine, University of Kansas, Kansas City, Kansas, USA.
Adriana FonsecaChildren's National Hospital, Washington, District of Columbia, USA.ORCID 0000-0002-6382-6833
Colette ShenDepartment of Radiation Oncology, University of North Carolina, Chapel Hill, North Carolina, USA.ORCID 0000-0002-3855-7360
Rebecca YodaDepartment of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA.ORCID 0000-0001-7866-5625
Lenore MonterrozaInova Schar Cancer Institute, Fairfax, Virginia, USA.
Adam L CohenInova Schar Cancer Institute, Fairfax, Virginia, USA.ORCID 0000-0002-8541-2287
Sahara CathcartUniversity of Nebraska Medical Center, Omaha, Nebraska, USA.ORCID 0009-0000-6504-2971
Md Al AminMayo Clinic, Rochester, Minnesota, USA.ORCID 0009-0001-5139-7234
Jian CampianMayo Clinic, Rochester, Minnesota, USA.ORCID 0009-0001-0355-0337
Kenneth AldapeCenter for Cancer Research, National Cancer Institute, Bethesda, Maryland, USA.ORCID 0000-0001-5119-7550

Funding

NIH HHSU.S. Department of Health and Human Services
6 · The paper itself

Abstract

backgroundHigh-grade astrocytoma with piloid features (HGAP) is a recently defined tumor type that is not well understood. Prognostic factors of clinical outcomes are not well established.

methodsMethylation profiling was performed on tumor samples, many at the National Cancer Institute (NCI) Laboratory of Pathology, and others from publicly available sources. Methylation classifier scores of ≥0.90 to the HGAP class on the NCI-Bethesda classifier version 3 were included. Clinical features were collected from the medical record. Survival analyses were performed using the Kaplan-Meier and Cox-proportional hazards methods.

resultsThe cohort comprised 421 patients. There were high rates of ATRX alteration (62%), CDKN2A/B homozygous loss (78%) and MGMT promoter methylation (53%). MAPK alterations were identified in 74% of evaluable samples. The median age was 46 years, and posterior fossa location was predominant (52%). The median overall survival was 88 months. Older age (P = .01) and the presence of an ATRX alteration (P = .04) were found to be negative prognostic factors. The presence of cystic features on magnetic resonance imaging (MRI) was found to be favorably prognostic (P = .01). Factors that were not significantly associated with prognosis included histologic high-grade features, CDKN2A/B homozygous deletion, MGMT promoter methylation, extent of resection, and presence of NF1 syndrome.

conclusionsThis large cohort establishes relative frequencies of several important markers. Additionally, older age, the presence of an ATRX alteration, and cystic features on MRI were found to be prognostic. Our work may aid in optimizing treatment regimens for patients with this tumor type.

Indexed as

AstrocytomaBiomarkers, TumorBrain NeoplasmsDNA MethylationAdolescentAdultAgedChildChild, PreschoolCohort StudiesCyclin-Dependent Kinase Inhibitor p16DNA HelicasesDNA Modification MethylasesDNA Repair EnzymesFemaleFollow-Up StudiesATRX protein, humanBiomarkers, TumorCyclin-Dependent Kinase Inhibitor p16DNA HelicasesDNA Modification MethylasesDNA Repair EnzymesMGMT protein, humanNuclear ProteinsTumor Suppressor ProteinsX-linked Nuclear ProteinATRX alterationDNA methylationHGAP

Identifiers

PMID42747321
PMCPMC13635591

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