(Press-News.org) CLEVELAND - A Case Comprehensive Cancer Center (CCCC) brain surgeon and neurosurgery professor is among the primary authors of a new approach to classifying tumors that could lead to significant improvements in their diagnosis and treatment. The research and recommendations appear online June 10 in The New England Journal of Medicine.
Andrew Sloan, MD, Director of the Brain Tumor and Neuro-Oncology Center at University Hospitals Case Medical Center, said the new classification system has the potential to provide far more accurate assessments of brain tumors known as low and intermediate grade gliomas (LGGs) - which in turn could enhance patients' outcomes.
Scientists and physicians from Cleveland and 43 other federally designated cancer centers used molecular and genetic analysis to develop an approach that reduces the role of individual observers' assessments of the tumors' appearance.
"This genome-wide analysis will be much more objective and likely will be practice changing," said Sloan, Professor of Neurosurgery and Vice Chair of Neurosurgery at Case Western Reserve School of Medicine. "It can be easily implemented and will markedly improve diagnosis, patient care and treatment planning."
Sloan said that the findings would need to be validated by other groups before they could be implemented in practice.
In the past, pathologists classified LGGs based on two primary factors: their presumed cell of origin (or lineage) and the degree of severity (graded I through IV, less to most severe) based on how the glia looked when viewed through a microscope. This classification, in turn, drove oncologists' decisions regarding treatment.
"Choice of therapy takes into account lineage and grade based on the microscopic appearance," explained Sloan, "which is necessarily subjective with variability between observers."
The new system shrinks six categories into three and also offers greater correlation between the classification and the patients' most likely prognosis. Under the existing model, some patients with low- or intermediate-grade gliomas suffered symptoms as quick and lethal as those with glioblastomas, considered the most severe form of brain tumor. Others with LGGs, meanwhile, had far better prognoses - even though their tumors' appearance strongly resembles ones with bleaker results.
To develop the new system, the study's authors performed genome-wide analysis of 293 adult LGGs from cancer centers that are part of the National Institutes of Health's Cancer Genome Atlas Research Network. A genome contains the complete set of DNA for an organism -in other words, its genetic information and instructions. Cancers emerge from errors in DNA, and the Atlas provides a national, coordinated effort to understand more about which of those errors contribute to the more than 200 kinds of cancer known to exist today.
For this project, the researchers applied such techniques as next-generation gene sequencing and then correlated the findings with data regarding patients' clinical outcomes -in this case, how long those with different molecular and genetic markers survived.
The researchers found that the characteristics of one group of LGGs had significant scientific similarities to those of glioblastomas, the most serious form of brain cancer. Patients with this kind of LGG had median survival rates of about 1.7 years. Those with glioblastomas have median survival rates of 1.1 years.
Patients with one of the other two kinds of LGG - also identified by scientific markers - had median survival rates of 6.3 and 8 years, respectively.
Sloan's team analyzed tissue samples of patients from the Seidman Cancer Center. As was the case with all other tissue samples, patients consented for the samples to be used for research, and their names were not attached to the data.
One of the markers -the IDH-1 mutation -previously has been linked to low- and intermediate gliomas; the U.S. Food and Drug Administration already has approved testing for its presence. Some brain tumor centers have used it - as well as the other two markers (P53 and LOH at 1p and 19q) have for years.
"The findings demonstrate that these three groups of LGGs can be identified objectively by three different markers," Sloan said. "While different centers have been using various markers, this study should validate these three markers as the accepted standards."
INFORMATION:
The study's lead author is Daniel J. Brat, MD, PhD, a medical school professor at Emory University and member of its Winship Cancer Institute. Other Case Comprehensive Cancer Center members of the involved with the study are Jill S. Barnholtz-Sloan, PhD, Wendi Barrett, Karen Devine, BS, RN, CCRN, and Jordonna Fulop, ASN, RN. (Barrett, Devine and Fulop are also with UH). The study was funded by multiple grants from the National Institutes of Health in support of the Cancer Genome Atlas, including one to the Case Western Reserve School of Medicine.
PHILADELPHIA -- Community health workers (CHW) are expected to be a growing and vital part of healthcare delivery in the United States as the Affordable Care Act is fully implemented. A slate of steps detailing how CHW programs can maximize their effectiveness and impact on patients and healthcare spending is provided in a new perspective piece in the New England Journal of Medicine by experts at the University of Pennsylvania's Perelman School of Medicine and New York University.
The piece offers guidance for the growing number of organizations who are looking to community ...
Montréal, June 10, 2015 - A Montréal research team, co-supervised by Dr. Rémi Rabasa-Lhoret from the IRCM and Dr. Laurent Legault from the Montreal Children's Hospital, undertook the first paediatric outpatient study to compare three alternative treatments for type 1 diabetes. The results, published this week in the scientific journal The Lancet Diabetes & Endocrinology, shows the dual-hormone artificial pancreas provides the most benefits by reducing the time spent in nocturnal hypoglycaemia.
The study conducted with children and adolescents with type ...
MINNEAPOLIS - Specialized brain proteins that are involved in the removal of damaged nerve cell materials may be detected in the blood of people who were diagnosed with mild cognitive impairment or dementia due to Alzheimer's disease. In a select group of people who later developed dementia, the levels of the lysosomal proteins were abnormal while the people still had no problems with memory or thinking skills, according to a study published in the June 10, 2015, online issue of Neurology®, the medical journal of the American Academy of Neurology.
"These proteins ...
MINNEAPOLIS - While participating in physical activities such as bike riding, dancing, walking and gardening and mentally stimulating activities such as crosswords and reading may reduce the risk of Alzheimer's disease, they may not do so by affecting the underlying markers for the disease, according to a study published in the June 10, 2015, online issue of Neurology®, the medical journal of the American Academy of Neurology.
"While a lifelong history of physical and mental activity may support better memory and thinking performance, this relationship may possibly ...
CLEVELAND, June 8 -- As new research continues to document the incidence of bothersome hot flashes lasting into the mid-60s for many women, the medical industry has had to rethink the way it approaches menopause therapy. As a result, earlier this month The North American Menopause Society (NAMS) issued its statement on the continuing use of systemic hormone therapy after age 65.
'The official position of NAMS is that there shouldn't be hard and fast rules against hormones after age 65,' said Wulf Utian, M.D., medical director for NAMS. 'Yes, there may be safety concerns, ...
PITTSBURGH, June 10 -- Women who experience more hot flashes, particularly while sleeping, during the menopause transition are more likely to have brain changes reflecting a higher risk for cerebrovascular disease, such as stroke and other brain blood flow problems, according to a pilot study led by researchers at the University of Pittsburgh School of Medicine published online today in Menopause and funded by the National Institutes of Health.
More than 70 percent of women have hot flashes -- a sudden feeling of intense warmth and sweatiness -- while transitioning into ...
A new report by researchers at the Johns Hopkins Center for a Livable Future (CLF), in collaboration with the Baltimore Food Policy Initiative, found that one in four of the city's residents live in so-called food deserts with limited access to healthy foods.
The report, released today, is available online on the Center for a Livable Future's Maryland Food System Map website. The findings were highlighted at a press conference featuring Baltimore City Mayor Stephanie Rawlings-Blake, other city officials and CLF representatives.
Neighborhoods with food deserts have ...
MIAMI - An international team, led by researchers at the University of Miami (UM) Rosenstiel School of Marine and Atmospheric Science, has developed a new, timelier method to identify harmful bacteria levels on recreational beaches. The new model provides beach managers with a better prediction tool to identify when closures are required to protect beachgoers from harmful contaminates in the water.
"The development of this new model has allowed us, for the first time, to estimate contamination levels on beaches subject to nonpoint source pollution, in particular from ...
Short boys are three times more likely than short girls to receive recombinant human growth hormone treatment for idiopathic short stature (ISS), even though in a general pediatric population, equal proportions of both genders fall under the height threshold designating ISS. Researchers who analyzed records of over 283,000 U.S. children and adolescents found a clear-cut and persistent gender bias in the provision of treatment.
"Growth is an important sign of child health, so growth failure merits equal consideration for both boys and girls," said study leader Adda Grimberg, ...
DARIEN, IL - A new study suggest sleep problems and energy product use are associated with increased alcohol use in teens, even after controlling for sociodemographics and mental health.
Results show that both sleeping problems and use of energy products are associated with greater risk of alcohol use in teenagers, according to a study conducted by the RAND Corporation.
"Our findings suggest that teenagers may be using highly caffeinated energy products to cope with sleep loss, and both sleep problems and energy product use are associated with increased risk of alcohol ...
