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Comparative Clinical and Imaging‐Based Evaluation of Therapeutic Modalities in CNS Embryonal Tumours With PLAGL Amplification




TekijätKeck, Michaela-Kristina; Tietze, Anna; Bison, Brigitte; Avula, Shivaram; Engelhardt, Julien; Faure-Conter, Cecile; Fenouil, Tanguy; Figarella-Branger, Dominique; Goebell, Einar; Gojo, Johannes; Haberler, Christine; Hakumaki, Juhana; Hayden, James T.; Korhonen, Laura S.; Koscielniak, Ewa; Kramm, Christof M.; Kranendonk, Mariette E. G.; Lequin, Maarten; Ludlow, Louise E.; Meyronet, David; Nyman, Per; Ora, Ingrid; Perwein, Thomas; Pesola, Jouni; Rauramaa, Tuomas; Reddingius, Roel; Samuel, David; Schouten-van Meeteren, Antoinette Y. N.; Sexton-Oates, Alexandra; Vasiljevic, Alexandre; von Kalle, Thekla; Wefers, Annika K.; Wesseling, Pieter; Zamecnik, Josef; Zapotocky, Michal; von Hoff, Katja; Jones, David T. W.

KustantajaWiley

KustannuspaikkaHOBOKEN

Julkaisuvuosi2025

JournalNeuropathology and Applied Neurobiology

Tietokannassa oleva lehden nimiNeuropathology and Applied Neurobiology

Lehden akronyymiNEUROPATH APPL NEURO

Artikkelin numeroe70015

Vuosikerta51

Numero2

Sivujen määrä11

ISSN0305-1846

eISSN1365-2990

DOIhttps://doi.org/10.1111/nan.70015

Verkko-osoitehttps://doi.org/10.1111/nan.70015

Rinnakkaistallenteen osoitehttps://research.utu.fi/converis/portal/detail/Publication/491847085


Tiivistelmä

Aims: Embryonal tumours with PLAGL1 or PLAGL2 amplification (ET, PLAGL) show substantial heterogeneity regarding their clinical characteristics and have been treated inconsistently, resulting in diverse outcomes. In this study, we aimed to evaluate the clinical behaviour of ET, PLAGL and elucidate their response pattern across the different applied treatment regimens.

Methods: We conducted an in-depth retrospective analysis of clinical and serial imaging data of 18 patients with ET, PLAGL (nine each of PLAGL1 and PLAGL2 amplified).

Results: Patients with PLAGL1-amplified tumours (ET, PLAGL1) had fewer relapses (3/9), while PLAGL2-amplified tumours (ET, PLAGL2) were prone to early relapse or progression (8/9) and to distant, leptomeningeal and intraventricular relapses. Progression-free survival differed significantly between the subtypes (log-rank test, p = 0.0055). Postoperative treatment included chemotherapy (n = 17, various protocols), alone (n = 8) or combined with radiotherapy (n = 9). Responses to chemotherapy were observed in both subtypes, and incomplete resection was not associated with inferior survival. All three survivors with ET, PLAGL2 were treated with induction and high-dose chemotherapy with (n = 1-low-dose CSI and boost) or without (n = 2) radiotherapy, whereas five patients with less intensive chemotherapy relapsed. All six survivors with ET, PLAGL1 were treated with conventional chemotherapy regimens, with (n = 4-local radiotherapy n = 3; CSI and boost n = 1) or without (n = 2) radiotherapy. Two patients with ET, PLAGL1 relapsed after 8 years.

Conclusions: Adjuvant therapy should be considered for all ET, PLAGL patients: Patients with ET, PLAGL2 might benefit from intensified chemotherapy regimens. In contrast, patients with ET, PLAGL1 showed superior outcomes without high-dose chemotherapy or craniospinal irradiation.


Ladattava julkaisu

This is an electronic reprint of the original article.
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Julkaisussa olevat rahoitustiedot
We thank all contributors of clinical data for the cases presented in Table 1, namely, Martin McCabe (University of Manchester, UK), Federico Roncaroli (University of Manchester, UK), David Solomon (University of California San Francisco, USA), Nasir Ud Din (The Aga Khan University, Pakistan), Suzanne J. Baker (St. Jude Children's Research Hospital, USA), Florian Selt (Hopp Children's Cancer Center Heidelberg [KiTZ], Germany), Jonas Ecker (Hopp Children's Cancer Center Heidelberg [KiTZ], Germany), Till Milde (Hopp Children's Cancer Center Heidelberg [KiTZ], Germany), Andreas von Deimling (University Hospital Heidelberg, Germany) and Andrey Korshunov (University Hospital Heidelberg, Germany). Open Access funding enabled and organized by Projekt DEAL.


Last updated on 2025-21-05 at 11:33