HGG-05. Systematic review of diffuse hemispheric glioma, H3 G34-mutant and clinical factors influencing outcomes
Bibliographic record
Abstract
Abstract BACKGROUND: A comprehensive description of clinical features and factors impacting prognosis for patients with diffuse hemispheric glioma, H3 G34-mutant (DHG H3G34) is not easily accessible. Understanding survival data and prognostic features is paramount for clinical advancements and ensuring patients/families are fully informed. METHODS: To summarize clinical, basic histomolecular, and treatment variables and their impacts on survival of DHG H3G34, a systematic review was undertaken. PubMed, Embase, and Google Scholar were searched for English articles published between January 1, 2012, and June 30, 2021. Eligible studies included patient(s) of any age diagnosed with an H3 G34-mutant brain tumour with at least one measure of survival or progression. A protocol was prospectively registered in PROSPERO (CRD42021267764) and PRISMA guidelines were followed. RESULTS: 27 studies met criteria for inclusion (13 pediatric-focused, 3 adult-focused, and 11 all ages). 135 unique patients with DHG H3G34 were included (118 G34R, 8 G34V, and 9 determined via methylation alone). Median age at diagnosis was 15.8 years (IQR=13.3-22.0). At presentation, 90% had localized disease. Co-occurring alterations included ATRX mutation 93%, TP53 mutation 88%, PDGFRA mutation 46%, PDGFRA amplification 13%, and MGMT promoter methylation in 70%. 89% of patients reported progressive disease with a median time-to-progression of 10.0 months. At last follow-up, 71% had died. Median time from progression to death was 5.0 months (IQR=3.0-12.0). Median overall survival was 17.3 months (95% CI 13.5-21.1) with a 1-, 2-, 3-, 5-year survival of 75, 39, 24, and 12%, respectively. Factors found to influence survival duration were presence of MGMT promoter methylation (HR=0.48, 95% CI 0.25-0.90) and less than near-total resection upfront (HR=3.59, 95% CI 2.07-6.22). CONCLUSION: This review highlights the poor prognosis, available survival measures, important prognostic features of DHG G34, and serves as a baseline for future clinical trials, though further study to identify prognostic biomarkers is needed.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.011 | 0.046 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.011 | 0.008 |
| Bibliometrics | 0.019 | 0.018 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.010 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".