The correlation between IDH-1 mutation and overall survival in Iranian patients with high grade gliomas

Abstract

Introduction: Despite advances in diagnostic procedures and treatment modalities, high grade gliomas have poor prognosis and low overall survival (OS) time. Novel prognostic biomarkers such as mutations in metabolic enzyme of isocitrate dehydrogenases-1 (IDH1) were linked to cancer patient prognosis and therapeutic response. The aim of this study was to investigate the frequency of IDH1 mutation and its associations with OS in patients with high-grade gliomas.

Methods: A total of 75 patients with histologically confirmed high-grade gliomas (WHO grades III and IV) were retrospectively recruited from patients referred to the clinical oncology department of Ahvaz Golestan Hospital, Iran from 2013 to 2020. All patients received the standard treatment (surgery, radiotherapy and chemotherapy with temozolomide). Immunohistochemical method was used to determine the mutation in IDH-1 gene. The overall survival distributions were estimated using Kaplan-Meier method and compared between subgroups by Log-rank test.

Results: The patients included 17 (22.7%) grade III and 58 (77.3%) grade IV tumors. IDH1 mutant Type was found in 24 patients (32%), including 12 case (70.59%) in grade III and 12 case (20.69) in grade IV glioma (P<0.0001). Furthermore, IDH1 mutant was more likely to exhibit in secondary gliomas other than primary tumors (71.43% vs. 27.94%; P=0.019). The number of death patients in the IDH1 mutation group was lower than in the wild type (26.23% vs. 73.77%; P=0.030). In the survival analysis, patients with IDH1 mutations had better OS compared to those with wild-type IDH1 (median 21 vs. 12 months; P=0.017).

Conclusion: According to our results, IDH1 mutant is more likely to exhibit in grade III and secondary gliomas. Patients with IDH1 mutations had longer life compared to those with wild-type IDH1. This finding suggest that IDH-1 mutation was a positive prognostic factor for OS in high grade gliomas.