Clinical roles of EGFR amplification in diffuse gliomas: a real-world study using the 2021 WHO classification of CNS tumors

Hai Wang; Xin Zhang; Jiahui Liu; Wenlin Chen; Xiaopeng Guo; Yaning Wang; Yuekun Wang; Hao Xing; Tingyu Liang; Yixin Shi; Delin Liu; Tianrui Yang; Yu Xia; Junlin Li; Jiaming Wu; Qianshu Liu; Tian Qu; Siying Guo; Huanzhang Li; Kun Zhang; Yilin Li; Shanmu Jin; Dachun Zhao; Yu Wang; Wenbin Ma

doi:10.3389/fnins.2024.1308627

Clinical roles of EGFR amplification in diffuse gliomas: a real-world study using the 2021 WHO classification of CNS tumors

Front Neurosci. 2024 Feb 26:18:1308627. doi: 10.3389/fnins.2024.1308627. eCollection 2024.

Authors

Hai Wang^#¹, Xin Zhang^#¹, Jiahui Liu^#¹, Wenlin Chen^#¹, Xiaopeng Guo^#^{1

2}, Yaning Wang¹, Yuekun Wang¹, Hao Xing¹, Tingyu Liang¹, Yixin Shi^{1

3}, Delin Liu^{1

3}, Tianrui Yang^{1

3}, Yu Xia^{1

3}, Junlin Li^{1

3}, Jiaming Wu^{1

3}, Qianshu Liu^{1

3}, Tian Qu^{1

3}, Siying Guo^{1

3}, Huanzhang Li^{1

3}, Kun Zhang^{1

3}, Yilin Li^{1

4}, Shanmu Jin^{1

4}, Dachun Zhao⁵, Yu Wang^{1

2}, Wenbin Ma^{1

2}

Affiliations

¹ Department of Neurosurgery, Center for Malignant Brain Tumors, National Glioma MDT Alliance, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
² China Anti-Cancer Association Specialty Committee of Glioma, Beijing, China.
³ Eight-year Medical Doctor Program, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
⁴ "4+4" Medical Doctor Program, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
⁵ Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

^# Contributed equally.

Abstract

Background: The 2021 World Health Organization Classification of Central Nervous System Tumors updates glioma subtyping and grading system, and incorporates EGFR amplification (Amp) as one of diagnostic markers for glioblastoma (GBM).

Purpose: This study aimed to describe the frequency, clinical value and molecular correlation of EGFR Amp in diffuse gliomas based on the latest classification.

Methods: We reviewed glioma patients between 2011 and 2022 at our hospital, and included 187 adult glioma patients with available tumor tissue for detection of EGFR Amp and other 59 molecular markers of interest. Clinical, radiological and pathological data was analyzed based on the status of EGFR Amp in different glioma subtypes.

Results: 163 gliomas were classified as adult-type diffuse gliomas, and the number of astrocytoma, oligodendroglioma and GBM was 41, 46, and 76. EGFR Amp was more common in IDH-wildtype diffuse gliomas (66.0%) and GBM (85.5%) than IDH-mutant diffuse gliomas (32.2%) and its subtypes (astrocytoma, 29.3%; oligodendroglioma, 34.8%). EGFR Amp did not stratify overall survival (OS) in IDH-mutant diffuse gliomas and astrocytoma, while was significantly associated with poorer OS in IDH-wildtype diffuse gliomas, histologic grade 2 and 3 IDH-wildtype diffuse astrocytic gliomas and GBM.

Conclusion: Our study validated EGFR Amp as a diagnostic marker for GBM and still a useful predictor for shortened OS in this group.

Keywords: 2021 WHO classification of central nervous system tumors; EGFR amplification; diffuse gliomas; glioblastoma; integrated diagnosis.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was funded by the CAMS Innovation Fund for Medical Sciences (2021-I2M-1-014), the National High-Level Hospital Clinical Research Funding (2022-PUMCH-A-019) and the Beijing Municipal Natural Science Foundation (7202150) for YuW, the National High-Level Hospital Clinical Research Funding (2022-PUMCH-B-113), the Tsinghua University-Peking Union Medical College Hospital Initiative Scientific Research Program (2019ZLH101), and the Beijing Municipal Natural Science Foundation (19JCZDJC64200[Z]) for WM.