The genetics of glioblastoma

Published on December 31, 2015   26 min

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Other Talks in the Series: Cancer Genetics

Hello and welcome to this talk entitled The Genetics of Glioblastoma as part of the Henry Stewart Talks on the genetics of cancers. My name is Dr. Hai Yan. I am the Henry Friedman Professor of Neuro Oncology at Duke University where I reside as a member of the Department of Pathology under Preston Robert Tisch Brain Tumor Center.
It is my privilege to discuss this content matter with you today that honors the work of people before me such as doctors Henry Friedman, Darell Bigner, Bert Vogelstein and many other major contributors to the field of brain cancer research. Naturally, I will also include some summaries of some of the work I have contributed to this important field. This work outlines the approach many scientists take to making further discoveries for aid in understanding and the treatment of what is a terribly deadly disease. Let's get started.
I will break this talk down into three sections that go through and involving depths of detail into the genetics of glioblastoma. While the majority of this talk will highlight the most updated, presented work in the field, I will also spend some time providing a brief summary of glioma and the hierarchy by which we classified them. I will then explain to the extent if possible how and why the use of genetics impacts the brain cancer research and treatment. This field is a critically important work to solving the confused cells, rogue in their behavior as tumors and deadly in their impact on people. Lastly, I attempt to capture just how we use genomic research by using some compounding stories along the way. The featured is that of isocitrate dehydrogenase better referred to as IDH. A curious insight into how one genomic finding can unpack a wealth of knowledge about the mischievous inner workings of cancer cells. Finally, I'd like to share with you the very cutting-edge of genomic research by discussing a mutation we discovered just two years ago called TERT. I hope you enjoy the discussion. Now let's begin.
Glial cells are the most prevalent cells in brain and play critical roles through out our neurological functioning. Tumors of glial cells known as gliomas are the most common primary brain tumor in adults and account for 80 percent of all CNS malignancies. Gliomas are graded I to grade IV based on the histological and the clinical criteria set by the World Health Organization, WHO. Low-grade gliomas are generally slow growing. High grade tumors are rapidly growing, invasive malignancies risk poor prognoses. Glioblastoma multiforme also called GBM, WHO classification named glioblastoma is the most common and the most aggressive malignant primary brain tumor in humans, account for 20 percent of all intracranial tumors. GBM is a rare disease with an incidence of two to three cases per 100,000 person live years in Europe and in also America. About 50 percent of the patients diagnosed with GBM die within one year, while 90 percent within three years. Treatment of GBM can involve chemotherapy, radiation and surgery. Median survival with standard of care radiation and chemotherapy with temozolomide is 15 months. Median survival without treatment is 4.5 months.
The greatest distribution of tumor types, unfortunately for patient outcomes are typically the most lethal, that being glioblastoma or GBM. Approximately 55 percent of clinical representations share the histological features of GBM. Grade II and III tumor subtypes which are usually treatable through resection or pharmacological intervention account for most of the remaining tumor subtypes. Conventionally, we refer to GBMs, both primary and secondary as higher grade tumors and the remaining tumor types low grade.

The genetics of glioblastoma

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