Oligodendroglioma

What Causes Oligodendroglioma?

The root cause of a brain tumor is a mutation or damage in the genes that control the growth of affected cells. In a healthy cell, these genes prevent the cell from growing or reproducing too rapidly, and the genes can also determine the cell’s expected lifespan. In a tumor’s cells, the damage to the genes causes the cells to grow and reproduce rapidly, and the cells may live longer than usual. As this rapid growth and reproduction continue, the cells grow into an abnormal mass. In some cases, the tumor produces chemicals that stop the body’s immune system from fighting the cancer, and the tumor cells may also trigger an increase in blood supply to support their growth.

The specific cause of the gene damage that triggers a tumor’s formation is usually not identifiable. Some risk factors that may play a role include:

• Exposure to ultraviolet rays
• Exposure to ionizing radiation
• Exposure to some chemicals
• Chronic stress
• Poor diet

Is Oligodendroglioma Hereditary?

Most oligodendrogliomas do not appear to be linked to inherited traits. Instead, researchers believe most gene changes that cause tumors come from external environmental factors or changes within cells that occur randomly and with no external trigger. However, gene mutations that run in families may increase the risk of developing an oligodendroglioma in some cases.

How Is Oligodendroglioma Detected?

Grade II oligodendrogliomas can be challenging to detect early because their symptoms may be too subtle to notice in the early stages of their growth.

Seizures are the most common first sign of an oligodendroglioma. Most people with an oligodendroglioma experience seizure(s) before the tumor is diagnosed.

Some other common warning signs of oligodendrogliomas include:

• Headaches
• Problems concentrating
• Problems with memory
• Problems with balance or coordination
• Weakness or numbness

How Is Oligodendroglioma Diagnosed?

Doctors may take several different diagnostic steps when they suspect that a patient may have an oligodendroglioma.

• Neurological exam. A basic neurological exam will test a patient’s reflexes, balance, coordination, strength, vision, and hearing. The results of this exam may prompt a doctor to look further for a tumor’s presence, and it may give a clue to the affected part of the brain, if any.
• Imaging. Imaging technologies are non-invasive ways to look at brain tissue and possibly detect a tumor’s presence. They may also be used to judge the tumor’s size, location, and growth. Magnetic resonance imaging (MRI) uses a strong magnetic field to produce images of the brain and central nervous system. Computerized tomography (CT) scan may also be used to look for tumors.
• Biopsy. Doctors may require a biopsy, in which a sample of the tumor is removed and analyzed by a pathologist. The biopsy might be conducted with surgery or, if the tumor is in a particularly hard-to-reach area, using a needle guided by imaging technology. A pathologist’s examination of the tissue sample can help suggest the best treatment course.

How Is Oligodendroglioma Treated?

Treatment of an oligodendroglioma can vary depending on the tumor’s grade. Surgery to completely remove a tumor that has not infiltrated surrounding brain tissue is often successful. Surgery to remove higher-grade tumors is typically the first step, but the tumor’s growth into healthy brain tissue may make it impossible to remove all the cancer cells. Because of this, follow-up treatments with radiation and/or chemotherapy are generally necessary.

Surgery

The most direct way to treat a brain tumor is to remove as much of it as possible with surgical intervention. Typically, the surgery involves opening the skull and removing the tumor while not damaging the surrounding healthy tissue. However, when a tumor is located in an especially sensitive area or has infiltrated a critical part of the brain, the surgeon may not be able to remove all of the tumor, and other subsequent treatment options may be necessary.

Radiation Therapy

Radiation therapies involve using high-energy x-rays to target and kill tumor cells directly. The radiation is typically focused on the tumor so it does not damage healthy cells. Radiation therapy is often used when the tumor can’t be entirely removed with surgery or when the tumor is in a location that is not safely accessible.

Side effects of radiation therapy may include headaches, memory loss, fatigue, and scalp reactions.

Chemotherapy

Chemotherapy uses chemicals that intentionally damage the body’s cells with the expectation that healthy cells can more easily recover from the damage than can tumor cells. Chemotherapy can effectively treat some tumors, but its success rate is not high in treating most brain tumors. One obstacle is the body’s blood-brain barrier, a border of cells that protects the brain by blocking the transmission of many substances from the circulatory system into the vulnerable brain tissue. The blood-brain barrier may prevent chemotherapy drugs from reaching the tumor.

How Does Oligodendroglioma Progress?

The prognosis for a person with an oligodendroglioma depends on the tumor’s aggressiveness. Some oligodendroglioma may respond well to treatment, and a full recovery may be possible. About three-quarters of people with an oligodendroglioma survive at least five years after diagnosis. However, people with aggressive tumors that spread to other tissues may have a less favorable outcome.

How Is Oligodendroglioma Prevented?

There is no clear way to prevent an oligodendroglioma from occurring. Even the lifestyle changes that can decrease the risk of many other types of cancer, such as quitting smoking or maintaining a healthy weight, may not reduce the chance of developing a brain tumor.

The only widely accepted preventative measure for brain tumors is the avoidance of high doses of radiation to the head.

Oligodendroglioma Caregiver Tips

Caring for someone with a brain tumor can be even more challenging than the already high demands of caring for someone with any other type of severe and progressive illness. Along with the physical changes that make other cancers and serious illnesses so physically and emotionally exhausting, brain tumors also often produce psychological and cognitive changes in the patient that can threaten the caregiver’s well-being.

As you care for your loved one through the progressive stages of their illness, keep these tips in mind:

• Learn as much as possible about the potential effects of your loved one’s specific type of brain tumor. This will allow you to understand how the illness affects the sufferer’s behavior.
• Get help from your friends and family. Caring for a brain tumor patient is a huge task, and you shouldn’t try to do it alone.
• Take time whenever possible to step away from the patient and the illness and find time for yourself. Acknowledge that it is normal and acceptable to need occasional relief from caregiving burdens.
• Find a support group. It can be beneficial to learn that you are not alone and that other people understand what you are going through.

Many people with oligodendrogliomas also suffer from other brain and mental health-related issues, a condition called co-morbidity. Here are a few of the disorders commonly associated with these tumors:

• People with brain tumors often experience depression or anxiety.
• Personality changes resembling bipolar disorder are sometimes an indication of a brain tumor.

Oligodendroglioma Brain Science

Researchers are currently working on projects to increase our understanding of brain tumors and improve patients’ prognoses. Research is ongoing in areas ranging from risk factor identification to early diagnosis and more effective treatment.

Some currently active areas of research include:

• Gene research. Scientists are working to understand who is at risk for developing glioblastomas and find ways to prevent the development of the tumors.
• Blood-brain barrier research. Scientists are also trying to find ways to temporarily and safely disrupt the blood-brain barrier so that drug treatments can more effectively be delivered to the site of tumors.
• Targeted drugs and viral therapies. Research is ongoing into drugs and viral agents that can precisely and effectively attack cancer cells without damaging healthy cells.
• Imaging technologies. New imaging technologies are being developed to detect tumors at earlier stages and monitor treatment effects on existing tumors more closely.

Oligodendroglioma Research

Title: Implantable Microdevice In Primary Brain Tumors

Stage: Recruiting

Principal investigator: Pier Paolo Peruzzi, MD, PhD

Brigham and Women’s Hospital

Boston, MA

This pilot study will assess the safety and feasibility of using an implantable microdevice to measure local intratumor response to chemotherapy and other clinically relevant drugs in malignant brain tumors.

The device involved in this study is called a microdevice.

The drugs used in this study will only include drugs already used systemically to treat gliomas.

This research study is a Pilot Study, which is the first time investigators are examining this study device in brain tumors.

The FDA (the U.S. Food and Drug Administration) has not approved the microdevice as a treatment for any disease.

Investigators are studying the safety of the microdevice and the effects of different drugs for each specific tumor. Brain tumors are known to be very different from each other and respond differently to different drugs. Therefore, finding out what drugs have the best chance of working in each specific tumor would be very helpful.

This research study involves drugs released by a small device, as small as the tip of a needle, that is inserted into the tumor at the time of surgery and is removed at the end of the surgery. This research study aims to prove that microdevices can be used to determine which drugs have better effects on treating malignant brain tumors.

Participants will be in this research study for up to 30 days.

The expected enrollment is about 12 people.

Title: Protein Phosphatase 2A Inhibitor, in Recurrent Glioblastoma

Stage: Recruiting

Principal investigator: Eric C. Burton, MD

National Institutes of Health Clinical Center

Bethesda, MD

Background: The brain is separated from the rest of the bloodstream by the blood-brain barrier. The barrier is like a filter protecting the brain, but it is also a challenge when medicines need to get into the brain. Researchers want to give the new drug LB100 to people before brain tumor surgery. They will measure how much LB100 is in the blood and how much gets into the brain. This may help with using LB100 to treat brain tumors in the future.

Objective: To see if LB100 can pass into the brain.

Eligibility: People at least 18 years old with a brain tumor that requires surgery

Participants will have their brain surgery at the Clinical Center.

Participants will get a dose of the study drug through a plastic tube in a vein for 2 hours during surgery.

Participants will have blood taken seven times in the 8 hours after getting the study drug.

Tumor samples will be taken during surgery.

Participants will have a heart test after getting the study drug. Sticky pads on the skin will measure the electrical activity of the heart.

Two-three weeks after leaving the hospital, participants will have a follow-up visit. They will have a physical exam and blood tests.

One month after surgery, they will be contacted in person or by phone to see how they are doing.

Title: Abemaciclib in Patients With Oligodendroglioma

Stage: Recruiting

Principal investigator: Stephen Bagley, MD

University of Pennsylvania

Philadelphia, PA

This phase II, single-arm, open-label study looks at how well a drug called abemaciclib works in patients with recurrent oligodendroglioma.

Primary Objective:

• To determine the efficacy of abemaciclib for recurrent oligodendroglioma, as measured by the estimated proportion of patients alive without disease progression at six months from study enrollment (PFS-6)

Secondary Objectives:

• To evaluate the safety and tolerability of abemaciclib in recurrent oligodendroglioma
• To estimate the objective radiographic response rate (ORR) associated with abemaciclib in recurrent oligodendroglioma
• To determine the median progression-free survival (PFS) and overall survival (OS) of patients with recurrent oligodendroglioma treated with abemaciclib
• To determine ORR, PFS, and OS in the subgroup of recurrent oligodendroglioma patients with tumor CIC gene mutations

Exploratory Objectives:

• To measure pharmacodynamic markers of abemaciclib activity on oligodendroglial tumor cells
• To identify pre-treatment tumor characteristics associated with response to abemaciclib recurrent oligodendroglioma.