Actualité

dans

les tumeurs cérébrales

Prof J-Fr. BAURAINMedical Oncology Department

BSOP 2014Blankenberge23 Janvier 2015

UCLUniversitécatholiquede Louvain

King Albert II Cancer Institute, Université catholique de Louvain, Bruxelles, Belgium - This presentation is the intellectual propriety of Prof J-Fr. BAURAIN , Contact jf.baurain@uclouvain.be for permission to reprint and/or distribute Blankenberg - 15/01/23

Tumours in the Brain

HeadacheHTIC

Focal SignsEpilepsy, palsy

Clinic

Imagery

Brain MRIT1, T2, Flair, Gado

Nuclear MedecinePET-methionine

King Albert II Cancer Institute, Université catholique de Louvain, Bruxelles, Belgium - This presentation is the intellectual propriety of Prof J-Fr. BAURAIN , Contact jf.baurain@uclouvain.be for permission to reprint and/or distribute Blankenberg - 15/01/23

Tumours in the Brain

young patientsmelanoma

older patientslung cancers

Secondary lesions(metastases)

Primary lesions(brain tumour)

nerve, meningiaschwanoma, meningioma

glial cellsastrocytoma, oligodendroglioma

WHO 2007Blankenberg - 15/01/23

WHO Classification of CNS Tumours

King Albert II Cancer Institute, Université catholique de Louvain, Bruxelles, Belgium - This presentation is the intellectual propriety of Prof J-Fr. BAURAIN , Contact jf.baurain@uclouvain.be for permission to reprint and/or distribute

WHO 2007Blankenberg - 15/01/23

Proportion of the Different CNS Tumours

King Albert II Cancer Institute, Université catholique de Louvain, Bruxelles, Belgium - This presentation is the intellectual propriety of Prof J-Fr. BAURAIN , Contact jf.baurain@uclouvain.be for permission to reprint and/or distribute

xxxBlankenberg - 15/01/23

Anatomopathology of Glial Tumours

King Albert II Cancer Institute, Université catholique de Louvain, Bruxelles, Belgium - This presentation is the intellectual propriety of Prof J-Fr. BAURAIN , Contact jf.baurain@uclouvain.be for permission to reprint and/or distribute

xxxBlankenberg - 15/01/23

Overall Survival according to Grade

King Albert II Cancer Institute, Université catholique de Louvain, Bruxelles, Belgium - This presentation is the intellectual propriety of Prof J-Fr. BAURAIN , Contact jf.baurain@uclouvain.be for permission to reprint and/or distribute

xxxBlankenberg - 15/01/23

Grading = histological classification

King Albert II Cancer Institute, Université catholique de Louvain, Bruxelles, Belgium - This presentation is the intellectual propriety of Prof J-Fr. BAURAIN , Contact jf.baurain@uclouvain.be for permission to reprint and/or distribute

Subjectivity in the interpretationastrocytoma vs mixed gliomadiffuse astrocytoma vs pilocytic glioma

Interobserver variability10 cases10 anatomapathologistsless than 10% concordance

Necessity to have biomarkersdiagnosticprognosticpredictive

Reifenberg G., BANO 2013Blankenberg - 15/01/23

Genetic Anomalies in Glial Tumors

King Albert II Cancer Institute, Université catholique de Louvain, Bruxelles, Belgium - This presentation is the intellectual propriety of Prof J-Fr. BAURAIN , Contact jf.baurain@uclouvain.be for permission to reprint and/or distribute

Blankenberg - 15/01/23

Clinically Relevant Biomarkers

King Albert II Cancer Institute, Université catholique de Louvain, Bruxelles, Belgium - This presentation is the intellectual propriety of Prof J-Fr. BAURAIN , Contact jf.baurain@uclouvain.be for permission to reprint and/or distribute

Reifenberg G., BANO 2013

NOA-08 trial, W. WickBlankenberg - 15/01/23

MGMT promotor Methylation as a Predictive Marker

King Albert II Cancer Institute, Université catholique de Louvain, Bruxelles, Belgium - This presentation is the intellectual propriety of Prof J-Fr. BAURAIN , Contact jf.baurain@uclouvain.be for permission to reprint and/or distribute

Cairncross J,et al. JNCI 1998Blankenberg - 15/01/23

1p / 19q loss as Predictive Marker

King Albert II Cancer Institute, Université catholique de Louvain, Bruxelles, Belgium - This presentation is the intellectual propriety of Prof J-Fr. BAURAIN , Contact jf.baurain@uclouvain.be for permission to reprint and/or distribute

Hartmann et al. , Acta Neuropathol 2010Blankenberg - 15/01/23

IDH1 mutation as a Prognostic Marker

King Albert II Cancer Institute, Université catholique de Louvain, Bruxelles, Belgium - This presentation is the intellectual propriety of Prof J-Fr. BAURAIN , Contact jf.baurain@uclouvain.be for permission to reprint and/or distribute

Blankenberg - 15/01/23

Treatment of Glial Tumours

King Albert II Cancer Institute, Université catholique de Louvain, Bruxelles, Belgium - This presentation is the intellectual propriety of Prof J-Fr. BAURAIN , Contact jf.baurain@uclouvain.be for permission to reprint and/or distribute

SurgeryComplete resectionDiagnostic

Blankenberg - 15/01/23

Treatment of Glial Tumours

King Albert II Cancer Institute, Université catholique de Louvain, Bruxelles, Belgium - This presentation is the intellectual propriety of Prof J-Fr. BAURAIN , Contact jf.baurain@uclouvain.be for permission to reprint and/or distribute

Radiotherapystandard3D

SurgeryComplete resectionDiagnostic

Blankenberg - 15/01/23

Treatment of Glial Tumours

King Albert II Cancer Institute, Université catholique de Louvain, Bruxelles, Belgium - This presentation is the intellectual propriety of Prof J-Fr. BAURAIN , Contact jf.baurain@uclouvain.be for permission to reprint and/or distribute

SurgeryComplete resectionDiagnostic

Radiotherapystandard3D

ChemotherapyPBV / PCVTMZ

Blankenberg - 15/01/23

Treatment of Low Grade Gliomas (LGG), male 58 years

King Albert II Cancer Institute, Université catholique de Louvain, Bruxelles, Belgium - This presentation is the intellectual propriety of Prof J-Fr. BAURAIN , Contact jf.baurain@uclouvain.be for permission to reprint and/or distribute

Blankenberg - 15/01/23

Pronostic Markers of Low Grade Gliomas (LGG)

King Albert II Cancer Institute, Université catholique de Louvain, Bruxelles, Belgium - This presentation is the intellectual propriety of Prof J-Fr. BAURAIN , Contact jf.baurain@uclouvain.be for permission to reprint and/or distribute

Blankenberg - 15/01/23

Pronostic Markers of Low Grade Gliomas (LGG)

King Albert II Cancer Institute, Université catholique de Louvain, Bruxelles, Belgium - This presentation is the intellectual propriety of Prof J-Fr. BAURAIN , Contact jf.baurain@uclouvain.be for permission to reprint and/or distribute

Blankenberg - 15/01/23

Pronostic Markers of Low Grade Gliomas (LGG)

King Albert II Cancer Institute, Université catholique de Louvain, Bruxelles, Belgium - This presentation is the intellectual propriety of Prof J-Fr. BAURAIN , Contact jf.baurain@uclouvain.be for permission to reprint and/or distribute

Cairncross J,et al. JNCI 1998

Blankenberg - 15/01/23

Treatment of Low Grade Gliomas (LGG)

King Albert II Cancer Institute, Université catholique de Louvain, Bruxelles, Belgium - This presentation is the intellectual propriety of Prof J-Fr. BAURAIN , Contact jf.baurain@uclouvain.be for permission to reprint and/or distribute

Blankenberg - 15/01/23

High Risk LGG : added value of Chemotherapy ?

King Albert II Cancer Institute, Université catholique de Louvain, Bruxelles, Belgium - This presentation is the intellectual propriety of Prof J-Fr. BAURAIN , Contact jf.baurain@uclouvain.be for permission to reprint and/or distribute

Blankenberg - 15/01/23

Chemotherapy in place of Radiotherapy : EORTC 26033

King Albert II Cancer Institute, Université catholique de Louvain, Bruxelles, Belgium - This presentation is the intellectual propriety of Prof J-Fr. BAURAIN , Contact jf.baurain@uclouvain.be for permission to reprint and/or distribute

Blankenberg - 15/01/23

Treatment of Low Grade EORTC 26033 (LGG)

King Albert II Cancer Institute, Université catholique de Louvain, Bruxelles, Belgium - This presentation is the intellectual propriety of Prof J-Fr. BAURAIN , Contact jf.baurain@uclouvain.be for permission to reprint and/or distribute

Blankenberg - 15/01/23

Treatment of High Grade Gliomas (AA/AOD)

King Albert II Cancer Institute, Université catholique de Louvain, Bruxelles, Belgium - This presentation is the intellectual propriety of Prof J-Fr. BAURAIN , Contact jf.baurain@uclouvain.be for permission to reprint and/or distribute

Blankenberg - 15/01/23

Important the 1p / 19q Loss in grade III tumours

King Albert II Cancer Institute, Université catholique de Louvain, Bruxelles, Belgium - This presentation is the intellectual propriety of Prof J-Fr. BAURAIN , Contact jf.baurain@uclouvain.be for permission to reprint and/or distribute

Blankenberg - 15/01/23

Treatment of High Grade Gliomas (AA/AOD)

King Albert II Cancer Institute, Université catholique de Louvain, Bruxelles, Belgium - This presentation is the intellectual propriety of Prof J-Fr. BAURAIN , Contact jf.baurain@uclouvain.be for permission to reprint and/or distribute

Blankenberg - 15/01/23

Why 1p / 19q Loss associated with a better outcome

King Albert II Cancer Institute, Université catholique de Louvain, Bruxelles, Belgium - This presentation is the intellectual propriety of Prof J-Fr. BAURAIN , Contact jf.baurain@uclouvain.be for permission to reprint and/or distribute

Blankenberg - 15/01/23

Treatment of High Grade Gliomas : CATNON Study

King Albert II Cancer Institute, Université catholique de Louvain, Bruxelles, Belgium - This presentation is the intellectual propriety of Prof J-Fr. BAURAIN , Contact jf.baurain@uclouvain.be for permission to reprint and/or distribute

Blankenberg - 15/01/23

Treatment of Grade III Gliomas

King Albert II Cancer Institute, Université catholique de Louvain, Bruxelles, Belgium - This presentation is the intellectual propriety of Prof J-Fr. BAURAIN , Contact jf.baurain@uclouvain.be for permission to reprint and/or distribute

Blankenberg - 15/01/23

Treatment of Glioblastoma

King Albert II Cancer Institute, Université catholique de Louvain, Bruxelles, Belgium - This presentation is the intellectual propriety of Prof J-Fr. BAURAIN , Contact jf.baurain@uclouvain.be for permission to reprint and/or distribute

Nothing has changed

Blankenberg - 15/01/23

Genetic Classification of GBM

King Albert II Cancer Institute, Université catholique de Louvain, Bruxelles, Belgium - This presentation is the intellectual propriety of Prof J-Fr. BAURAIN , Contact jf.baurain@uclouvain.be for permission to reprint and/or distribute

Blankenberg - 15/01/23

Genetic Classification of GBM

King Albert II Cancer Institute, Université catholique de Louvain, Bruxelles, Belgium - This presentation is the intellectual propriety of Prof J-Fr. BAURAIN , Contact jf.baurain@uclouvain.be for permission to reprint and/or distribute

Blankenberg - 15/01/23

Treatment of High Grade Gliomas (GBM)

King Albert II Cancer Institute, Université catholique de Louvain, Bruxelles, Belgium - This presentation is the intellectual propriety of Prof J-Fr. BAURAIN , Contact jf.baurain@uclouvain.be for permission to reprint and/or distribute

Blankenberg - 15/01/23

Treatment of High Grade Gliomas : Stupp’s Study

King Albert II Cancer Institute, Université catholique de Louvain, Bruxelles, Belgium - This presentation is the intellectual propriety of Prof J-Fr. BAURAIN , Contact jf.baurain@uclouvain.be for permission to reprint and/or distribute

Blankenberg - 15/01/23

Treatment of High Grade Gliomas : Stupp’s Study

King Albert II Cancer Institute, Université catholique de Louvain, Bruxelles, Belgium - This presentation is the intellectual propriety of Prof J-Fr. BAURAIN , Contact jf.baurain@uclouvain.be for permission to reprint and/or distribute

Blankenberg - 15/01/23

Function of MGMT protein

King Albert II Cancer Institute, Université catholique de Louvain, Bruxelles, Belgium - This presentation is the intellectual propriety of Prof J-Fr. BAURAIN , Contact jf.baurain@uclouvain.be for permission to reprint and/or distribute

Blankenberg - 15/01/23

Methylation of the Promoter from MGMT Gene

King Albert II Cancer Institute, Université catholique de Louvain, Bruxelles, Belgium - This presentation is the intellectual propriety of Prof J-Fr. BAURAIN , Contact jf.baurain@uclouvain.be for permission to reprint and/or distribute

Blankenberg - 15/01/23

Importance of MGMT in Prognosis

King Albert II Cancer Institute, Université catholique de Louvain, Bruxelles, Belgium - This presentation is the intellectual propriety of Prof J-Fr. BAURAIN , Contact jf.baurain@uclouvain.be for permission to reprint and/or distribute

Blankenberg - 15/01/23

New Treatment in GBM : Cilengitide (Centric Trial)

King Albert II Cancer Institute, Université catholique de Louvain, Bruxelles, Belgium - This presentation is the intellectual propriety of Prof J-Fr. BAURAIN , Contact jf.baurain@uclouvain.be for permission to reprint and/or distribute

Blankenberg - 15/01/23

New Treatment in GBM : Avastin

King Albert II Cancer Institute, Université catholique de Louvain, Bruxelles, Belgium - This presentation is the intellectual propriety of Prof J-Fr. BAURAIN , Contact jf.baurain@uclouvain.be for permission to reprint and/or distribute

Blankenberg - 15/01/23

New Treatment in GBM : Avastin, BELOB Trial

King Albert II Cancer Institute, Université catholique de Louvain, Bruxelles, Belgium - This presentation is the intellectual propriety of Prof J-Fr. BAURAIN , Contact jf.baurain@uclouvain.be for permission to reprint and/or distribute

Blankenberg - 15/01/23

In Conclusion

King Albert II Cancer Institute, Université catholique de Louvain, Bruxelles, Belgium - This presentation is the intellectual propriety of Prof J-Fr. BAURAIN , Contact jf.baurain@uclouvain.be for permission to reprint and/or distribute

- Treatment of glial tumors needs multidisciplinar team

- Cure of these tumors remains a hope

- High risk low grade tumors need an adjuvant treatment

- Grade III glial tumours must be treated according to 1p/19q

- Treatment of GBM remains a challenge

- Around 10% of long survivors are seen in methMGMT GBM