Abstract Details

Title Treatment Outcomes In Patients With H3K27 M Variant Glioma

Topic Neuro-oncology

Presentation(s) P6 - Poster Session 6 (5:30 PM-6:30 PM)

Poster/Presentation
Number 4-004

Background H3 K27M glioma is an aggressive intracranial tumor located in midline structures. Outcomes are poor, with studies suggesting less than 10% survival rate within 2 years. The rarity of these tumors presents a challenge for research regarding optimal treatment regimens, as high quality trials are difficult to compile and most investigation is still in preliminary stages.

Objective We aim to compare emerging treatment protocols for H3 K27M glioma.

Design/Methods A case series was developed using 12 patients at the Barrow NeurologicaI Institute who were diagnosed with biopsy-proven H3 K27M glioma. These patients were followed through their known treatment course. Documented factors included initial treatment, best response to initial treatment, recurrences, second line treatments, response assessment criteria for all treatment rounds, any discovered metastases, and vital status by date of last contact.

Results Of the initial 12 patients, 5 were lost to follow-up before meaningful clinical outcomes could be recorded. Of the remaining 7, all underwent temozolomide and radiation as components of first-line treatment. After first-line treatment, 1/7 (14.2%) had partial response, 3/7 (42.8%) had stable disease, and 3/7 (42.8%) had progressive disease. 4 patients elected to undergo second line treatment: 2 underwent bevacizumab with lomustine, 1 underwent bevacizumab and irinotecan, and 1 underwent surgery with carmustine. Of the 2 who underwent bevacizumab and lomustine, 1 (50%) improved from progressive to stable disease and 1 (50%) stayed at stable disease. Of the 1 patient who underwent bevacizumab and lomustine, outcome worsened from stable to progressive disease. Of the 1 patient who underwent surgery and carmustine, outcome improved from progressive to stable disease.

Conclusions

Our study suggests that multiple rounds of therapy with chemoradiation may benefit patients with H3 K27M glioma. Specifically, bevacizumab/lomustine and surgery/carmustine appear to lead to promising outcomes. Further research is needed to focus on establishing evidence-based protocols of treatment.

Authors/Disclosures
Tejas Ranade, MD (10th Medical Group) PRESENTER	Dr. Ranade has nothing to disclose.
Sami Kaldawi, DO	Dr. Kaldawi has nothing to disclose.
Zain Ashary, MD (Rush University Medical Center)	Dr. Ashary has nothing to disclose.
Huiam Mubarak, MD (Barrow Neurological Institute)	Dr. Mubarak has nothing to disclose.
Ekokobe Fonkem, DO (Medical College of Wisconsin)	Dr. Fonkem has received personal compensation for serving as an employee of Barrow Neurological Institute. Dr. Fonkem has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bayer. Dr. Fonkem has stock in Global Cancer Technology.