CNS cancer

Question 1

What are the first line recommendations for management of GBM?

Answer 1

If <70 and KPS >70 then for surgery followed by concurrent RT with temozolamide followed by 6 cycles of adjuvant temozolamide. If >70 or KPS <70 consider BSC

Question 2

Average survival of GBM?

Answer 2

12-18months

Question 3

Is methylation of MGMT promotor associated with better or worse prognosis?

Answer 3

Better, and better response to temozolamide

Question 4

MGMT aberration is present in what proportion of GBM?

Answer 4

50%

Question 5

Are primary or secondary GBM (progressing from low grade astrocytoma or anaplastic astrocytoma) more commonly associated with IDH1 mutation?

Answer 5

Secondary GBM

Question 6

Second line treatments for GBM?

Answer 6

CCNU (lomustine)

Question 7

Management of meningioma?

Answer 7

Considered benign and if asymptomatic can be watched on serial scans. If compressing adjacent structures or very large then surgery or radiotherapy can be considered.

Question 8

What criteria is used to assess treatment response in brain tumours?

Answer 8

RANO criteria

Question 9

Which CNS tumour is associated with TERT promoter mutation?

Answer 9

IDH1 WT glioblastoma

Question 10

Which CNS tumour is associated with TERT promoter mutation?

Answer 10

IDH1 WT glioblastoma

Question 11

In elderly fit patients with MGMT promoter what may be a treatment option if surgery is not feasible/risky/declined?

Answer 11

Exclusive temozolamide chemotherapy