Glioblastoma multiforme classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Marjan Khan M.B.B.S.[2]

Overview

Glioblastoma multiforme may be classified into several subtypes based on the origin (primary and secondary) and molecular alterations (classic, proneural, mesenchymal, and neural).^[1]^[2]

Classification

Based on the origin

Glioblastoma multiforme may be classified according to the origin into two subtypes: Primary and secondary.^[1]


Subtype of Glioblastoma multiforme	Characteristic features

Primary glioblastoma multiforme	De novo origin More aggressive Occurs in older patients
Secondary glioblastoma multiforme	Arises from pre-existing lower grade gliomas Less aggressive Occurs in younger patients

Primary GBM is the most common form (about 95%) and arises typically de novo, within 3–6 months, in older patients.
Secondary GBM arises from prior low-grade astrocytomas (over 10–15 years) in younger patients.
Primary and secondary forms show some molecular differences.
The end result of both sub type is same since the same pathways are affected and respond similarly to current standard treatment.
Primary GBM often has amplified and mutated epidermal-growth factor receptor (EGFR) which encodes altered EGF receptor.
Secondary GBM has increased signaling through PDGF-A receptor.
Both types of mutations lead to increased tyrosine kinase receptor (TKR) activity and consequently to activation of RAS and PI3K pathways.

Based on the molecular alterations

Glioblastoma multiforme may be classified according to the molecular alterations into four subtypes:^[2]

Classic
Proneural
Mesenchymal
Neural

References

↑ ^1.0 ^1.1 Classification of Glioblastoma multiforme. Dr Dylan Kurda and Dr Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/Glioblastoma
↑ ^2.0 ^2.1 Verhaak RG, Hoadley KA, Purdom E, Wang V, Qi Y, Wilkerson MD; et al. (2010). "Integrated genomic analysis identifies clinically relevant subtypes of Glioblastoma multiforme characterized by abnormalities in PDGFRA, IDH1, EGFR, and NF1". Cancer Cell. 17 (1): 98–110. doi:10.1016/j.ccr.2009.12.020. PMC 2818769. PMID 20129251.

Template:WikiDoc Sources

[ddd-1] 1.0 ^1.1 Classification of Glioblastoma multiforme. Dr Dylan Kurda and Dr Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/Glioblastoma

[pmid20129251-2] 2.0 ^2.1 Verhaak RG, Hoadley KA, Purdom E, Wang V, Qi Y, Wilkerson MD; et al. (2010). "Integrated genomic analysis identifies clinically relevant subtypes of Glioblastoma multiforme characterized by abnormalities in PDGFRA, IDH1, EGFR, and NF1". Cancer Cell. 17 (1): 98–110. doi:10.1016/j.ccr.2009.12.020. PMC 2818769. PMID 20129251.

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