Molecular Profiling Reclassifies Adult Astroblastoma into Known and Clinically Distinct Tumor Entities with Frequent Mitogen‐Activated Protein Kinase Pathway Alterations

Conclusion.We suggest that gliomas with astroblastic features include a variety of molecularly sharply defined entities. Adult ABM harboring molecular features of PXA and HGG should be reclassified. Central nervous system high‐grade neuroepithelial tumors with MN1 alterations and histology of ABM appear to be uncommon in adults. Astroblastic morphology in adults should thus prompt thorough molecular investigation aiming at a clear histomolecular diagnosis and identifying actionable drug targets, especially in the mitogen‐activated protein kinase pathway.Implications for Practice.Astroblastoma (ABM) remains a poorly defined and controversial entity. Although meningioma 1 alterations seem to define a large subset of pediatric cases, adult cases remain molecularly poorly defined. This comprehensive molecular characterization of 1 adolescent and 14 adult ABM revealed that adult ABM histology comprises several molecularly defined entities, which explains clinical diversity and identifies actionable targets. Namely, pleomorphic xanthoastrocytoma‐like ABM cases show a favorable prognosis whereas high‐grade glioma (glioblastoma and diffuse midline gliome)‐like ABM show significantly worse clinical courses. These results call for in‐depth molecular analysis of adult gliomas with astroblastic features for diagnostic and therapeutic purposes.
Source: The Oncologist - Category: Cancer & Oncology Authors: Tags: Neuro-Oncology ‐ Source Type: research