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TERT promoter mutation is associated with worse prognosis in WHO grade II and III meningiomas

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Abstract

Introduction

Transcriptional activating mutations in the promoter region of the telomerase reverse transcriptase (TERT) gene occur at high frequency in various types of solid tumors and have also been reported for meningiomas. Especially for atypical and anaplastic meningiomas, the prognostic relevance of TERT promoter mutation is yet unclear. The present study aimed to analyze the frequency of TERT promoter mutation and define its long-term prognostic significance beyond clinical and histological factors in a cohort of meningiomas WHO grade II and III.

Methods

Patients undergoing surgical resection of aggressive meningiomas were included. Analysis for C228T and C250T mutation in the TERT promoter region was performed using PCR method. Patients were stratified into two groups (TERT mutated vs. TERT wild type). Univariate analysis was conducted using molecular and histological factors.

Results

87 patients with atypical (N = 72) and anaplastic meningiomas (N = 15) were included in the study. TERT promoter region was found to be mutated in 4 WHO grade II and 2 WHO grade III meningiomas. TERT promoter mutation was associated with shorter progression free survival than TERT wild type meningiomas (median PFS 12.5 vs. 26 months, p = .004). In the univariate analysis, TERT promoter mutation had a strong prognostic value on overall survival (p = .009) and progression free survival.

Conclusions

Presence of TERT promoter mutation is associated with shorter progression free survival and overall survival in meningiomas WHO grade II and III. In these tumors, TERT promoter mutation should be considered as a clinically relevant prognostic factor to identify high risk patients.

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Authors and Affiliations

  1. Department of Neurosurgery, Ludwig-Maximilians-University Munich, Marchioninistr. 15, 81377, Munich, Germany

    Annamaria Biczok, Bogdana Suchorska, Nicole A. Terpolilli, Jun Thorsteinsdottir, Joerg C. Tonn & Christian Schichor

  2. Center for Neuropathology and Prion Research, Ludwig-Maximilians-University Munich, Munich, Germany

    Theo Kraus & Armin Giese

  3. German Cancer Consortium (DKTK), Partner Site Munich, and German Cancer Research Center (DKFZ), Heidelberg, Germany

    Annamaria Biczok, Bogdana Suchorska, Nicole A. Terpolilli, Jun Thorsteinsdottir, Armin Giese, Joerg C. Tonn & Christian Schichor

  4. University Institute of Pathology, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria

    Theo Kraus

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Correspondence to Annamaria Biczok.

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The authors have no personal, financial, or institutional interest in any of the drugs, materials, or devices described in this article. There is no conflict of interest.

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The study was approved by the local ethics committee at the authors’institution.

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Biczok, A., Kraus, T., Suchorska, B. et al. TERT promoter mutation is associated with worse prognosis in WHO grade II and III meningiomas. J Neurooncol 139, 671–678 (2018). https://doi.org/10.1007/s11060-018-2912-7

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