The next in our "Best Post of the Month" series is from November 18, 2011:
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Over 1400 attendees at 2011 SNO meeting in Anaheim |
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Dr. Aldape discussed brain tumor biomarkers |
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Same view as above, at 40X |
Neuropathology took center stage at the Society for Neuro-Oncology (SNO) meeting today as
Dr. Kenneth D. Aldape,
neuropathogist at the University of Texas MD Anderson Cancer, was
introduced as the next president of the society. Dr. Aldape also
delivered an address to more than 1400 attendees about the future of
surgical neuropathological reporting. Aldape's research centers on the
clinical utility of brain tumor biomarkers as prognostic indicators. He
described how the use of biomarkers will change the way surgical
neuropathology diagnoses are rendered. He noted that the broad
morphologic spectrum one sees in gliomas makes the recommendations of
the World Health Organization sometimes difficult to implement. For
example, the difference between a WHO grade II and grade III astrocytoma
is based principally on whether or not mitotic figures are "brisk" as
interpreted by the examining neuropathologist. Yet, the imprecision of
that approach is obvious when one considers variables such as the
diligence of the neuropathologist in identifying mitotic figures, the
often equivocal morphology of apoptotic-versus-mitotic cells, as well as
the variable technical quality of tissue processing and staining. The
use of biomarkers will make diagnoses more reliable and will provide
more useful prognostic information to the oncologist. Dr. Aldape
projected onto the screen an example of a recent surgical
pathology report he had generated at MD
Anderson. The report highlighted the status of the several biomarkers,
including G-CIMP, IDH1, pHH3, MIB1, 1p/19q deletion, and MGMT. Then,
only in the
last sentence of the comment, was it noted that the histology and
biomarker profile was most consistent with a WHO grade III (anaplastic)
astrocytoma. It was as if the WHO diagnosis and grade were a perfunctory
afterthought. Finally, Aldape noted that biomarkers will become even
more important in the coming years as biomarker data becomes
"actionable", allowing the oncologist to personalize the treatment of a
particular tumor depending on the biomarker profile. These are exciting
times....
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