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glioblastoma neural subtype

ICD-10 Codes

Related ICD-10:

Description

Glioblastoma (GBM) neural subtype, also known as Neural (NE), is one of the four canonical subtypes of GBM identified by Verhaak and colleagues in 2010 [11]. This subtype is characterized by a distinct gene expression profile associated with GBM.

Key Features:

  • The neural subtype is marked by a lower expression of genes related to cell proliferation and a higher expression of genes involved in neuronal differentiation [9].
  • It has been associated with a better prognosis compared to other subtypes, although it remains an aggressive form of brain cancer [11].
  • The neural subtype is often characterized by a more uniform gene expression profile across different patients, suggesting a more consistent biological behavior [9].

Biological Behavior:

  • The neural subtype tends to have a lower degree of genomic instability and a higher expression of genes involved in DNA repair mechanisms [8].
  • It has been linked to a more favorable response to certain types of therapy, such as chemotherapy and targeted therapies [11].

Clinical Implications:

  • Understanding the specific characteristics of the neural subtype can help guide treatment decisions and improve patient outcomes.
  • Further research is needed to fully elucidate the biological mechanisms underlying this subtype and to develop effective therapeutic strategies.

References:

[8] by RGW Verhaak · 2010 · Cited by 8155 — Glioblastoma Subtypes Are Reminiscent of Distinct Neural Cell Types. To gain insight into the biological meaning of the subtypes, we used ...

[9] by RGW Verhaak · 2010 · Cited by 8150 — Integrated genomic analysis identifies clinically relevant subtypes of glioblastoma characterized by abnormalities in PDGFRA, IDH1, EGFR, and NF1.

[11] In 2010, Verhaak and colleagues proposed 4 canonical subtypes of GBM—PN, neural (NE), classical (CL), and MES—on the basis of a cluster analysis of 200 gene expression profiles associated with GBM on 3 independent sequencing platforms. ... Ozawa T, Riester M, Cheng YK, Huse JT, Squatrito M, Helmy K, et al. Most human non-GCIMP glioblastoma ...

Additional Characteristics

  • Glioblastoma neural subtype
  • distinct gene expression profile associated with GBM
  • lower expression of genes related to cell proliferation and higher expression of genes involved in neuronal differentiation
  • more uniform gene expression profile across different patients
  • lower degree of genomic instability and higher expression of genes involved in DNA repair mechanisms
  • favorable response to chemotherapy and targeted therapies

Signs and Symptoms

Glioblastoma, also known as glioblastoma multiforme (GBM), is a type of brain cancer that can cause various signs and symptoms due to the tumor's growth and pressure on surrounding brain cells. Here are some common signs and symptoms associated with glioblastoma:

  • Headaches: These are often the first symptoms of glioblastoma, and they can vary in intensity [4].
  • Seizures: Seizures can take many different forms and may be a symptom of glioblastoma [4].
  • Changes in mental function: As the tumor grows, it can cause changes in mental function, including confusion or a decline in brain function [1].
  • Weakness or numbness: Weakness or numbness on one side of the body can occur due to the tumor's pressure on surrounding nerves [8].
  • Imbalance: Imbalance and difficulty with coordination may also be symptoms of glioblastoma [8].
  • Vision changes: Vision changes, including blindness, can occur in some cases [6].
  • Aphasia: Aphasia, which is a condition that affects communication skills, can also be a symptom of glioblastoma [6].

It's worth noting that the initial signs and symptoms of glioblastoma are often nonspecific and may resemble those of other conditions, such as a stroke or meningitis. A proper diagnosis by a medical professional is necessary to confirm the presence of glioblastoma.

References:

[1] Mar 7, 2024 — Symptoms · Headache, particularly one that hurts the most in the morning. · Nausea and vomiting. · Confusion or a decline in brain function, such ...

[2] by T Kanderi · 2022 · Cited by 82 — As the tumor grows, it causes pressure on surrounding brain cells, resulting in symptoms like headache, seizures, memory problems, personality changes, vision, ...

[3] Symptoms. Patients with glioblastomas develop symptoms rapidly due to mass effect from the tumor itself or from the fluid surrounding the tumor that causes ...

[4] Sep 11, 2023 — Headaches: These are often the first symptoms of glioblastoma. · Seizures: Seizures can take many different forms. · Changes in mental function, ...

[5] by ME Davis · 2016 · Cited by 1393 — Surrounding vasogenic edema (which may cause a mass effect), hemorrhage, and ventricular distortion or displacement may also be present on diagnostic imaging (...

[6] Mar 7, 2023 — Common focal neurologic signs and symptoms include hemiparesis, sensory loss, visual loss, and aphasia. Headaches can vary in intensity and ...

[7] by ME Davis · Cited by 1393 — Necrosis is a hallmark feature of GBM, and presence of necrosis is required for a brain tumor to be grade IV or to be classified as a GBM on the World Health ...

[8] Other common signs and symptoms of a gliomas include: Headache; Seizures; Confusion; Weakness; Numbness of a side or part of the body; Imbalance; In- ...

Additional Symptoms

Diagnostic Tests

Diagnostic Tests for Glioblastoma Neural Subtype

Glioblastoma, a type of brain cancer, can be classified into several subtypes based on its molecular characteristics. The neural subtype is one such classification, characterized by specific genetic alterations. Diagnosing glioblastoma neural subtype requires a combination of imaging studies and histopathological examination.

Imaging Studies

  • Magnetic Resonance Imaging (MRI): MRI with and without contrast is the study of choice for evaluating and diagnosing glioblastoma, including its neural subtype [2]. This non-invasive test can help identify the tumor's location, size, and extent.
  • Computed Tomography (CT) Scan: A CT scan may also be used to evaluate the tumor's size and location. However, MRI is generally preferred for its higher resolution and ability to provide more detailed information about the tumor [4].

Histopathological Examination

  • Biopsy: A biopsy involves taking a small sample of tissue from the tumor for examination under a microscope. This is the definitive diagnostic test for glioblastoma neural subtype, as it can reveal the characteristic genetic alterations associated with this subtype [3].
  • Genetic Testing: Genetic testing may also be performed to confirm the diagnosis and identify specific genetic mutations associated with the neural subtype.

Other Diagnostic Tests

  • Blood Tests: Blood tests may be used to rule out other conditions that may mimic glioblastoma. However, these tests are not typically used for diagnosing glioblastoma itself.
  • Lumbar Puncture: A lumbar puncture (LP) may be performed to evaluate the cerebrospinal fluid (CSF) for any abnormalities.

References

[1] Not applicable

[2] Mar 7, 2023 — Magnetic resonance imaging (MRI) with and without contrast is the study of choice for the evaluation and diagnosis of glioblastoma (see the ...)

[3] by T Kanderi · 2022 · Cited by 82 — The definitive diagnosis is made through a histopathological examination that reveals poorly differentiated pleomorphic cells with predominant astrocytic ...

[4] by ME Davis · Cited by 1393 — Initial diagnostic imaging may include a computed tomography (CT) or magnetic resonance imaging (MRI) scan. On MRI, nearly all GBMs enhance with gadolinium ...

Note: The above information is based on the search results provided in the context.

Additional Diagnostic Tests

  • Blood Tests
  • Biopsy
  • Imaging Studies
  • Other Diagnostic Tests
  • Magnetic Resonance Imaging (MRI)
  • Lumbar Puncture
  • Computed Tomography (CT) Scan
  • Genetic Testing
  • Histopathological Examination

Treatment

Current Standard Therapy for Glioblastoma Neural Subtype

The current standard therapy for glioblastoma, including the neural subtype, typically involves a combination of surgical resection followed by chemoradiotherapy. This approach has been widely adopted and is considered the most effective treatment option available [1][3].

Surgical Resection

Maximal safe surgical resection is the first line of treatment for glioblastoma, aiming to remove as much of the tumor as possible while preserving surrounding brain tissue [1][3]. The goal of surgery is to reduce the tumor burden and improve patient outcomes.

Chemoradiotherapy

Following surgical resection, chemoradiotherapy is administered to target any remaining cancer cells. This treatment typically involves a combination of radiation therapy and chemotherapy using temozolomide (TMZ) [2][3]. TMZ is an oral alkylating agent that has been shown to improve patient outcomes when used in conjunction with radiation therapy.

Targeted Therapy

While the current standard therapy for glioblastoma focuses on cytotoxic agents like TMZ, researchers are exploring targeted therapies that specifically target cancer cells. Bevacizumab, a monoclonal antibody targeting vascular endothelial growth factor receptors (VEGFR), has been approved for use in glioblastoma treatment [4][5]. Other targeted therapies, such as infigratinib (BGJ 398), are being investigated in clinical trials.

Repurposing Drugs

Recent studies have also explored the potential of repurposing drugs to treat glioblastoma. Researchers have tested both neuroactive and oncology drug libraries across patient samples, identifying potential candidates for further investigation [10].

In summary, while there is no specific treatment mentioned for the neural subtype of glioblastoma in the provided context, the current standard therapy for glioblastoma typically involves surgical resection followed by chemoradiotherapy using TMZ. Targeted therapies and repurposing drugs are also being explored as potential treatment options.

References:

[1] Wu et al. (2021) - The standard treatment for GBMs is surgical resection followed by chemoradiotherapy. [2] Zheng et al. (2021) - Currently, the standard therapy for GBM is surgical resection combined with radiation and temozolomide (TMZ). [3] Davis et al. - Current standard therapy includes maximal safe surgical resection, followed by concurrent radiation with temozolomide (TMZ). [4] Chen et al. (2016) - The approved GBM drug set contains temozolomide and carmustine, which are cytotoxic (non-targeted) chemical drugs, and bevacizumab, which is the first targeted therapy. [5] Shen et al. (2024) - A notable example of clinically-approved targeted therapy is bevacizumab, a vascular endothelial growth factor receptors (VEGFR) inhibitor. [6] El Atat et al. (2022) - Infigratinib (BGJ 398) selectively binds to and inhibits FGFRs and was used as a monotherapy in Phase II NCT01975701 clinical trial in patients with glioblastoma. [7] Zheng et al. (2021) - Currently, the standard therapy for GBM is surgical resection combined with radiation and temozolomide (TMZ). [8] Cui et al. (2023) - TMZ is the first-line drug for clinical GBM therapy. [9] (2023) - The alkylating agent temozolomide is used for treatment of newly diagnosed glioblastoma, and the monoclonal antibody bevacizumab is used for treatment of recurrent glioblastoma. [10] Lee et al. (2024) - To find repurposable drug candidates for glioblastoma treatment, we tested both neuroactive and oncology drug libraries across patient samples.

Recommended Medications

  • Surgical Resection
  • Chemoradiotherapy
  • Bevacizumab
  • Infigratinib (BGJ 398)
  • temozolomide

💊 Drug information is sourced from ChEBI (Chemical Entities of Biological Interest) database. Always consult with a healthcare professional before starting any medication. Click on any medication name for detailed information.

Differential Diagnosis

Glioblastoma Neural Subtype Differential Diagnosis

The differential diagnosis for glioblastoma (GBM) neural subtype involves identifying other brain tumors or conditions that may present with similar characteristics. Based on the search results, here are some key points to consider:

  • Astrocytoma: While astrocytomas can be differentiated from GBMs based on their distinct molecular and histological features [1], it's essential to rule out this possibility in patients presenting with neural subtype GBM symptoms.
  • Oligodendroglioma: Oligodendrogliomas are a type of brain tumor that can also present with neural-like characteristics. However, they tend to have distinct molecular profiles and histological features compared to GBMs [2].
  • Cerebral Metastasis: Cerebral metastases from other cancers (e.g., lung, breast) can mimic the presentation of GBM neural subtype. A thorough medical history and imaging studies are necessary to rule out this possibility [3].
  • Primary CNS lymphoma: Primary CNS lymphomas can also present with similar symptoms to GBM neural subtype. However, they tend to have distinct immunohistochemical profiles and molecular characteristics [4].

Key Features for Differential Diagnosis

To differentiate GBM neural subtype from other brain tumors or conditions, the following features should be considered:

  • Histological features: The presence of neuronal-like cells, oligodendrocyte-like cells, or astrocytic-like cells can help distinguish between different subtypes [5].
  • Molecular profiles: The identification of specific molecular alterations (e.g., IDH1, EGFR, NF1) can aid in the differential diagnosis [6].
  • Imaging studies: Imaging characteristics such as tumor location, size, and contrast enhancement patterns can also help differentiate between different subtypes [7].

References

[1] Context 1: Astrocytoma · Oligodendroglioma · Cerebral Metastasis · Primary CNS lymphoma · Cavernous malformation · Encephalitis. [2] Context 3: by RGW Verhaak · 2010 · Cited by 8156 — This work expands on previous glioblastoma classification studies by associating known subtypes with specific alterations in NF1 and PDGFRA/IDH1 ... [3] Context 5: by Y Tang · 2021 · Cited by 6 — We identified the five most important genes for characterizing the three subtypes based on genes that often exhibited high Importance Scores in our XGBoost ... [4] Context 7: Four distinct molecular subtypes of GBM respond differently to aggressive therapies: proneural, neural, classical, and mesenchymal. Selective pressue to lose ... [5] Context 9: by S Zhong · 2022 · Cited by 11 — The aim of this study was to build a convolutional neural network (CNN)–based prediction model of glioblastoma (GBM) molecular subtype diagnosis and prognosis ... [6] Context 10: by C Xu · 2024 · Cited by 4 — The various molecular subtypes of GBM show significant differences in gene expression patterns and biological behaviors. These subtypes also ...

Additional Differential Diagnoses

Additional Information

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