[PDF][PDF] Molecular, pathological, radiological, and immune profiling of non-brainstem pediatric high-grade glioma from the HERBY phase II randomized trial

A Mackay, A Burford, V Molinari, DTW Jones… - Cancer cell, 2018 - cell.com
A Mackay, A Burford, V Molinari, DTW Jones, E Izquierdo, J Brouwer-Visser, F Giangaspero…
Cancer cell, 2018cell.com
The HERBY trial was a phase II open-label, randomized, multicenter trial evaluating
bevacizumab (BEV) in addition to temozolomide/radiotherapy in patients with newly
diagnosed non-brainstem high-grade glioma (HGG) between the ages of 3 and 18 years.
We carried out comprehensive molecular analysis integrated with pathology, radiology, and
immune profiling. In post-hoc subgroup analysis, hypermutator tumors (mismatch repair
deficiency and somatic POLE/POLD1 mutations) and those biologically resembling …
Summary
The HERBY trial was a phase II open-label, randomized, multicenter trial evaluating bevacizumab (BEV) in addition to temozolomide/radiotherapy in patients with newly diagnosed non-brainstem high-grade glioma (HGG) between the ages of 3 and 18 years. We carried out comprehensive molecular analysis integrated with pathology, radiology, and immune profiling. In post-hoc subgroup analysis, hypermutator tumors (mismatch repair deficiency and somatic POLE/POLD1 mutations) and those biologically resembling pleomorphic xanthoastrocytoma ([PXA]-like, driven by BRAF_V600E or NF1 mutation) had significantly more CD8+ tumor-infiltrating lymphocytes, and longer survival with the addition of BEV. Histone H3 subgroups (hemispheric G34R/V and midline K27M) had a worse outcome and were immune cold. Future clinical trials will need to take into account the diversity represented by the term "HGG" in the pediatric population.
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