Highlights and Selected Abstracts from SNO 2014

No. AT-13: “R9802: Phase III study of radiation therapy (RT) with or without procarbazine, CCNU, and vincristine (PCV) in low-grade glioma: Results by histologic type” was presented by Jan Buckner. This presentation expanded on an earlier announcement at ASCO in June 2014 which showed that the combination of radiotherapy (RT) and PCV (procarbazine, CCNU and vincristine) prolonged both PFS and OS compared with RT alone in patients with low grade glioma (LGG). The treatment effect was greatest in patients with oligodendroglioma (O) and oligoastrocytoma (OA) where the study achieved statistical significance. Investigators are now focusing on assessing the outcomes by molecular markers, in particular IDH mutations and 1p/19q co-deletion. The Adult Epidemiology Research Award was awarded to Abstract No. ED-36: “Inherited variants near TERC and TERT are associated with longer telomeres and increased glioma risk: genome-wide association results from the UCSF Adult Glioma Study and the ENGAGE Consortium Telomere Group” which was presented by Kyle Walsh. This study identified three new SNPs (single nucleotide polymorphisms) located near TERC, TERT and RTEL1 which were associated with increased high grade glioma risk. These findings suggest that inherited variations in telomere length or telomerase activity may underlie glioma susceptibility. Abstract No. GE-41: “Comprehensive and integrative genomic characterisation of diffuse lower grade gliomas” was presented by Roel Verhaak. This study found that molecular characterisation of low grade gliomas (LGG) points toward three distinct subtypes which traversed grades and histologies: • IDH wildtype – GBM like, poor outcome • IDH mutant with 1p/19q codeletion – mostly oligodendroglioma; TERT promoter mutations • IDH mutant non 1p/19q codeletion – TP53 and ATRX mutations, mixed grade and histology They concluded that IDH1, IDH2 mutation status and 1p/19q ploidy are routinely determined in the clinical setting, making these three subtypes highly practical to implement, and proposed that classification of LGG be revised based on these molecular characteristics.No. GE-41: “Comprehensive and integrative genomic characterisation of diffuse lower grade gliomas” was presented by Roel Verhaak. This study found that molecular characterisation of low grade gliomas (LGG) points toward three distinct subtypes which traversed grades and histologies: • IDH wildtype – GBM like, poor outcome • IDH mutant with 1p/19q codeletion – mostly oligodendroglioma; TERT promoter mutations • IDH mutant non 1p/19q codeletion – TP53 and ATRX mutations, mixed grade and histology They concluded that IDH1, IDH2 mutation status and 1p/19q ploidy are routinely determined in the clinical setting, making these three subtypes highly practical to implement, and proposed that classification of LGG be revised based on these molecular characteristics. After the morning tea break, Ken Aldape delivered the Abhijit Guha Lecture with a speech titled: “Neuropathologists: Who Needs Them?” This was followed by this year’s recipient of the Victor Levin Award, Michael Prados, who was fittingly introduced by Victor Levin. In a departure from recent lectures, Prados gave a non-technical speech entitled: “Success or Significance”. He characterised success as: “Often identified by personal milestones; focuses on individual achievements; can ebb and flow, often never enough”. He explained that significance: “Lasts, carries on beyond success, Victor Levin introduces 2014 Victor Levin Award winner, Michael Prados and beyond personal milestones; can take us out of our comfort zone; and once achieved, not much