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The Neuro Center's physician newsletter. Click here to go to Neurogram's home page or the University of Virginia Health System's Neuro-Oncology pages. Molecular CytogeneticsThe University of Virginia is proud to announce a new test that will provide hope to some neuro-oncology patients. Gliomas are the most common, harmful primary brain tumor. Until very recently the prognosis was poor for most patients. About 25 to 30 percent of all gliomas, however, have an oligodendroglial component that make them sensitive to chemotherapy. In 1998, a researcher at London Regional Cancer Center discovered that patients with tumors that had 1p or 19q chromosomal deletions were likely to respond to chemotherapy. These patients survived longer than those whose tumors did not have these features. Traditional neuropathological tests, however, cannot distinguish these deletions. The University of Virginia now offers molecular cytogenetic testing of primary brain tumors to detect these deletions. A fluorescence microscope is used to conduct fluorescence in situ hybridization (FISH) chromosomal analysis. UVa is the first institution in the Mid Atlantic region to offer this test on a routine basis for glioma deletions. The test also gives hope to the 5 to 10 percent of patients with glioblastomas and anaplastic astrocytomas that exhibit the 1p chromosomal deletion. Normally these common, malignant tumors have a much worse prognosis. Patients with tumors that show these deletions typically will be offered chemotherapy through our oncology division and enjoy a better prognosis than patients evaluated with conventional neuropathological methods. We foresee that this molecular cytogenetic technology will let us study many other genetic and biochemical pathways through our active clinical trials program. We now will be able to correlate the genetic and biochemical pathways of a tumor and its responsiveness to specific treatments. Knowing a tumor's particular genetic changes will let us select a rational therapy or therapies that can specifically target the pathway(s) disrupted in that tumor. We have developed a growing database that will link each patient's tumor type and cytogenetic profile with each treatment and the outcome of that treatment. The more data we gather, the more effectively we will be able to treat our patients. Clinical Trials
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