Less than 5% of patients diagnosed with glioblastoma (IDH-wildtype, grade 4) survive more than two years despite intense treatment. A crucial aspect of their rapid progression may lie in the tumors' ability to quickly form recurrences that become increasingly more aggressive and resistant to therapy. New ways to improve clinical care, e.g., by identifying therapeutical targets or methods to predict the clinical course, are urgently required. In this project, we investigated four promising targets that yield potential as a biomarker or therapeutical target (RPS27, MPS1, PCDHGC3, BRMS1) and used a Magnet Resonance Imaging approach to search for predictors of the clinical course, tumor growth patterns, and patients' survival by analyzing data obtained in clinical routine. Also, we adapted to the rapidly changing challenges during the COVID-19 pandemic by evaluating the use of newly established remote video consultations in neuro-oncology. Almost 1,000 patients treated at the University Hospitals of Wuerzburg, Bonn, and Essen were included in the subprojects. We found RPS27, MPS1, PCDHGC3, and BRMS1 to be dysregulated in gliomas. Whereas RPS27 showed an overexpression independent of WHO grade, survival, or other tumor/patient characteristics, MPS1 and PCDHGC3 were associated with multiple factors, including patients' survival. RPS27 may yield value as a biomarker, while MPS1 might serve as a therapeutic target. In addition, we could show that treatment with TTFields may influence tumor regrowth by enhancing local control. Distant recurrences were more commonly associated with multifocal or multicentric growth than local recurrences/progression. Multicentric and multifocal growth, however, show distinct differences in survival, which further supports the hypothesis of a different origin. Remote consultations will likely remain a valuable supplement to consultations in person in specialized clinical care in neuro-oncology due to their rising acceptance among patients, potential positive emotional impact, and better accessibility for patients from rural regions and with a poor clinical state.
Jonas Feldheim (Sat,) studied this question.