EP12.16 NEXT-GENERATION SEQUENCING IN IDH-WILDTYPE GLIOBLASTOMA: A PATHWAY TO PRECISION THERAPEUTICS

Abstract BACKGROUND IDH-wild-type glioblastomas are one of the most aggressive brain tumors in the adult population with a dismal prognosis. Despite radiation therapy and chemotherapy, the prognosis of this category remains grim with a 5-year survival rate remaining 5% and a median survival rate of 12-18 months. In the era of precision medicine, it is necessary to find molecular targeted genes for which targeted therapy is available MATERIAL AND METHODS Next-generation sequencing (NGS) was carried out in ten histologically and molecularly proven IDH-wild type glioblastomas. RESULTS Among the ten patients of glioblastoma, we have found out that five patients had mutations or fusions, against which targeted therapy is available. Two patients had PIK3CA mutation (targeted therapy Alpesilib), one patient has RET mutation (targeted therapy Selpercatinib & Pralsetinib), one patient had GOPC-ROS1 fusion (targeted therapy Crizotinib, Entrectinib & Repoctrectinib), one patient had PTPRZ1-MET fusion (targeted therapy Capmatinib & Tepotinib) and one patient had FGFR3-TACC3 fusion (targeted therapy Erdafitinib, Anlotinib, etc). CONCLUSION While the standard treatment for glioblastoma has remained unchanged for the last 15 years, targeted therapy holds promise. However, due to BBB (blood-brain barrier), tumor heterogeneity, and resistance mechanisms developed by glioma cells, the success rate of targeted therapy has not been promising. However ongoing research is going on to overcome BBB like using nanocarriers, combination with immunotherapy or chemotherapy, etc. Although we have limitation of cases, 50% of our cases have shown mutation or fusion, against which targeted therapy is available. This holds future promise for targeted therapy for IDH-wild type glioblastoma.