Web-based app predicts glioma mutations

A new web-based program will provide a simple, free way for health care providers to determine which brain tumor cases require testing for a genetic mutation.

Gliomas, a type of tumor that begins in the brain or spine, are the most common and deadly form of brain cancer in adults, making up approximately 80% of cases of malignant brain cancer. In some of these cases, patients have a mutation in a specific gene, known as an IDH1 mutation. Patients who have this mutation tend to survive years longer than those who do not carry the mutation.

The program, developed by University of Kentucky Markey Cancer Center researchers in Lexington, uses a statistical model to accurately predict the likelihood that a patient carries the IDH1 mutation and requires screening. Health care providers need only answer four questions in the application. The program is available online at www.kcr.uky.edu/webapps/IDH/app.html.

Gliomas are often tested for IDH1 mutation following surgery to remove the tumor, but undergoing this type of testing often requires stringent insurance preapprovals due to rising health care costs, explained Craig Horbinski, MD, PhD, of the University of Kentucky. This model was 94% accurate in predicting the IDH1/2 mutation status of gliomas from The Cancer Genome Atlas. This study was published in Neuro-Oncology (2014; doi:10.1093/neuonc/nou097).

"Currently, there are no universally accepted guidelines for when gliomas should be tested for this mutation," Horbinski said. "Obtaining insurance preapproval for additional molecular testing is becoming more commonplace, and this program will assist health care providers with an evidence-based rationale for when IDH1 screening is necessary."

In addition, Horbinski noted that the program can help conserve research dollars by helping brain cancer researchers identify which specific older gliomas in tumor banks—those removed at a time before IDH1 testing was routine—should be tested as data for research projects.

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