Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Treatment Decisions of World Health Organization Grade II and III Ependymomas in Molecular Era

  • Jung, Tae-Young (Department of Neurosurgery, Chonnam National University Hwasun Hospital, Chonnam National University Medical School) ;
  • Jung, Shin (Department of Neurosurgery, Chonnam National University Hwasun Hospital, Chonnam National University Medical School) ;
  • Kook, Hoon (Department of Pediatrics, Chonnam National University Hwasun Hospital, Chonnam National University Medical School) ;
  • Baek, Hee-Jo (Department of Pediatrics, Chonnam National University Hwasun Hospital, Chonnam National University Medical School)
  • Received : 2017.12.29
  • Accepted : 2018.02.14
  • Published : 2018.05.01
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Abstract

Surgery and radiotherapy are mainstays of treatment for ependymomas (EPNs). Recent molecular subgrouping could be superior to histopathological grading for predicting the prognosis of patients with EPNs. Gross total resection is an effective treatment approach regardless of its locations or pathologic grades. Adjuvant therapeutic strategies could be decided based on molecular subgrouping with risk-stratification. Information of histologic-molecular biology is now providing clues to therapeutic insights.

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References

  1. Aizer AA, Ancukiewicz M, Nguyen PL, Macdonald SM, Yock TI, Tarbell NJ, et al. : Natural history and role of radiation in patients with supratentorial and infratentorial WHO grade II ependymomas: results from a population-based study. J Neurooncol 115 : 411-419, 2013 https://doi.org/10.1007/s11060-013-1237-9
  2. Archer TC, Pomeroy SL : Posterior fossa ependymomas: a tale of two subtypes. Cancer Cell 20 : 133-134, 2011 https://doi.org/10.1016/j.ccr.2011.08.003
  3. Benesch M, Weber-Mzell D, Gerber NU, von Hoff K, Deinlein F, Krauss J, et al. : Ependymoma of the spinal cord in children and adolescents: a retrospective series from the HIT database. J Neurosurg Pediatr 6 : 137-144, 2010 https://doi.org/10.3171/2010.5.PEDS09553
  4. Brandes AA, Cavallo G, Reni M, Tosoni A, Nicolardi L, Scopece L, et al. : A multicenter retrospective study of chemotherapy for recurrent intracranial ependymal tumors in adults by the Gruppo Italiano Cooperativo di Neuro-Oncologia. Cancer 104 : 143-148, 2005 https://doi.org/10.1002/cncr.21110
  5. Chai YH, Jung S, Lee JK, Kim IY, Jang WY, Moon KS, et al. : Ependymomas: prognostic factors and outcome analysis in a retrospective series of 33 patients. Brain Tumor Res Treat 5 : 70-76, 2017 https://doi.org/10.14791/btrt.2017.5.2.70
  6. Chamberlain MC, Johnston SK : Temozolomide for recurrent intracranial supratentorial platinum-refractory ependymoma. Cancer 115 : 4775-4782, 2009 https://doi.org/10.1002/cncr.24524
  7. DeWire M, Fouladi M, Turner DC, Wetmore C, Hawkins C, Jacobs C, et al. : An open-label, two-stage, phase II study of bevacizumab and lapatinib in children with recurrent or refractory ependymoma: a collaborative ependymoma research network study (CERN). J Neurooncol 123 : 85-91, 2015 https://doi.org/10.1007/s11060-015-1764-7
  8. Ellison DW, Kocak M, Figarella-Branger D, Felice G, Catherine G, Pietsch T, et al. : Histopathological grading of pediatric ependymoma: reproducibility and clinical relevance in European trial cohorts. J Negat Results Biomed 10 : 7, 2011 https://doi.org/10.1186/1477-5751-10-7
  9. Gilbert M, Yuan Y, Wani K, Wu J, Omuro A, Lieberman F, et al. : A phase II study of lapatinib and dose dense temozolomide (TMZ) for adults with recurrent ependymoma: a CERN clinical trial. Neuro Oncol 16(suppl_5) : v13, 2014
  10. Gojo J, Lotsch D, Spiegl-Kreinecker S, Pajtler KW, Neumayer K, Korbel P, et al. : Telomerase activation in posterior fossa group A ependymomas is associated with dismal prognosis and chromosome 1q gain. Neuro Oncol 19 : 1183-1194, 2017 https://doi.org/10.1093/neuonc/nox027
  11. Gornet MK, Buckner JC, Marks RS, Scheithauer BW, Erickson BJ : Chemotherapy for advanced CNS ependymoma. J Neurooncol 45 : 61-67, 1999 https://doi.org/10.1023/A:1006394407245
  12. Korshunov A, Witt H, Hielscher T, Benner A, Remke M, Ryzhova M, et al. : Molecular staging of intracranial ependymoma in children and adults. J Clin Oncol 28 : 3182-3190, 2010 https://doi.org/10.1200/JCO.2009.27.3359
  13. Leeper H, Felicella MM, Walbert T : Recent advances in the classification and treatment of ependymomas. Curr Treat Options Oncol 18 : 55, 2017 https://doi.org/10.1007/s11864-017-0496-7
  14. Louis DN, Perry A, Reifenberger G, von Deimling A, Figarella-Branger D, Cavenee WK, et al. : The 2016 World Health Organization classification of tumors of the central nervous system: a summary. Acta Neuropathol 131 : 803-820, 2016 https://doi.org/10.1007/s00401-016-1545-1
  15. Mack SC, Taylor MD : Put away your microscopes: the ependymoma molecular era has begun. Curr Opin Oncol 29 : 443-447, 2017 https://doi.org/10.1097/CCO.0000000000000411
  16. Mack SC, Witt H, Piro RM, Gu L, Zuyderduyn S, Stutz AM, et al. : Epigenomic alterations define lethal CIMP-positive ependymomas of infancy. Nature 506 : 445-450, 2014 https://doi.org/10.1038/nature13108
  17. Mansur DB, Perry A, Rajaram V, Michalski JM, Park TS, Leonard JR, et al. : Postoperative radiation therapy for grade II and III intracranial ependymoma. Int J Radiat Oncol Biol Phys 61 : 387-391, 2005 https://doi.org/10.1016/j.ijrobp.2004.06.002
  18. Massimino M, Solero CL, Garre ML, Biassoni V, Cama A, Genitori L, et al. : Second-look surgery for ependymoma: the Italian experience. J Neurosurg Pediatr 8 : 246-250, 2011 https://doi.org/10.3171/2011.6.PEDS1142
  19. Merchant TE, Li C, Xiong X, Kun LE, Boop FA, Sanford RA : Conformal radiotherapy after surgery for paediatric ependymoma: a prospective study. Lancet Oncol 10 : 258-266, 2009 https://doi.org/10.1016/S1470-2045(08)70342-5
  20. Metellus P, Guyotat J, Chinot O, Durand A, Barrie M, Giorgi R, et al. : Adult intracranial WHO grade II ependymomas: long-term outcome and prognostic factor analysis in a series of 114 patients. Neuro Oncol 12 : 976-984, 2010 https://doi.org/10.1093/neuonc/noq047
  21. Modena P, Buttarelli FR, Miceli R, Piccinin E, Baldi C, Antonelli M, et al. : Predictors of outcome in an AIEOP series of childhood ependymomas: a multifactorial analysis. Neuro Oncol 14 : 1346-1356, 2012 https://doi.org/10.1093/neuonc/nos245
  22. Nakamura T, Fukuoka K, Ikeda J, Yoshitomi M, Udaka N, Tanoshima R, et al. : Encouraging option of multi-staged gross total resection for a C11orf-RelA fusion-positive supratentorial anaplastic ependymoma. Brain Tumor Pathol 34 : 160-164, 2017 https://doi.org/10.1007/s10014-017-0297-5
  23. Pajtler KW, Mack SC, Ramaswamy V, Smith CA, Witt H, Smith A, et al. : The current consensus on the clinical management of intracranial ependymoma and its distinct molecular variants. Acta Neuropathol 133 : 5-12, 2017 https://doi.org/10.1007/s00401-016-1643-0
  24. Pajtler KW, Pfister SM, Kool M : Molecular dissection of ependymomas. Oncoscience 2 : 827-828, 2015
  25. Pajtler KW, Witt H, Sill M, Jones DT, Hovestadt V, Kratochwil F, et al. : Molecular classification of ependymal tumors across all CNS compartments, histopathological grades, and age groups. Cancer Cell 27 : 728-743, 2015 https://doi.org/10.1016/j.ccell.2015.04.002
  26. Panwalkar P, Clark J, Ramaswamy V, Hawes D, Yang F, Dunham C, et al. : Immunohistochemical analysis of H3K27me3 demonstrates global reduction in group-A childhood posterior fossa ependymoma and is a powerful predictor of outcome. Acta Neuropathol 134 : 705-714, 2017 https://doi.org/10.1007/s00401-017-1752-4
  27. Parker M, Mohankumar KM, Punchihewa C, Weinlich R, Dalton JD, Li Y, et al. : C11orf95-RELA fusions drive oncogenic $NF-{\kappa}B$ signalling in ependymoma. Nature 506 : 451-455, 2014 https://doi.org/10.1038/nature13109
  28. Paulino AC : The local field in infratentorial ependymoma: does the entire posterior fossa need to be treated? Int J Radiat Oncol Biol Phys 49 : 757-761, 2001 https://doi.org/10.1016/S0360-3016(00)01353-5
  29. Paulino AC, Wen BC : The significance of radiotherapy treatment duration in intracranial ependymoma. Int J Radiat Oncol Biol Phys 47 : 585-589, 2000 https://doi.org/10.1016/S0360-3016(99)00535-0
  30. Ramaswamy V, Hielscher T, Mack SC, Lassaletta A, Lin T, Pajtler KW, et al. : Therapeutic impact of cytoreductive surgery and irradiation of posterior fossa ependymoma in the molecular era: a retrospective multicohort analysis. J Clin Oncol 34 : 2468-2477, 2016 https://doi.org/10.1200/JCO.2015.65.7825
  31. Ruda R, Bosa C, Magistrello M, Franchino F, Pellerino A, Fiano V, et al. : Temozolomide as salvage treatment for recurrent intracranial ependymomas of the adult: a retrospective study. Neuro Oncol 18 : 261-268, 2016 https://doi.org/10.1093/neuonc/nov167
  32. Venkatramani R, Dhall G, Patel M, Grimm J, Hawkins C, McComb G, et al. : Supratentorial ependymoma in children: to observe or to treat following gross total resection? Pediatr Blood Cancer 58 : 380-383, 2012 https://doi.org/10.1002/pbc.23086
  33. Venkatramani R, Ji L, Lasky J, Haley K, Judkins A, Zhou S, et al. : Outcome of infants and young children with newly diagnosed ependymoma treated on the “Head Start” III prospective clinical trial. J Neurooncol 113 : 285-291, 2013 https://doi.org/10.1007/s11060-013-1111-9
  34. Vera-Bolanos E, Aldape K, Yuan Y, Wu J, Wani K, Necesito-Reyes MJ, et al. : Clinical course and progression-free survival of adult intracranial and spinal ependymoma patients. Neuro Oncol 17 : 440-447, 2015 https://doi.org/10.1093/neuonc/nou162
  35. Witt H, Mack SC, Ryzhova M, Bender S, Sill M, Isserlin R, et al. : Delineation of two clinically and molecularly distinct subgroups of posterior fossa ependymoma. Cancer Cell 20 : 143-157, 2011 https://doi.org/10.1016/j.ccr.2011.07.007

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