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Abstract Details

Smoking-related Genomic Alterations Are Observed in Patients with Glioma and May Contribute to Shortened Survival
Neuro-oncology
P4 - Poster Session 4 (11:45 AM-12:45 PM)
5-017
To evaluate associations between smoking status, genetic alterations in primary glial neoplasms, and impact on survival.
Cigarette smoking may contribute to cancer-associated genomic instability with increased tumor mutation burden and frequency of KRAS, TP53, and other alterations. Few studies have explored smoking-associated genomic instability in patients with primary glioma.
Retrospective analysis was performed of adults (≥18 years) diagnosed with glioma (i.e., glioblastoma, astrocytoma, oligodendroglioma; WHO Grade 1–4) between 2000-2023, receiving primary oncologic care at Wake Forest Baptist Comprehensive Cancer Center, and available data on smoking status. Data was queried for demographic, clinical, molecular, and treatment characteristics. Smoking status was defined as active/former vs never smoker. P-value <0.05 defined as significant and <0.25 after multiple testing correction.
721 patients were identified; mean age 54.9±16 years at diagnosis and 58.2±14.3 at death or follow-up; 57% male; 58% GBM, 23% astrocytoma, 16% oligodendroglioma, 3% other glioma by 2016 WHO classification. Of these, 68.5% were never smokers and 31.4% current/former smokers; mean smoking duration 8±13 years. Most frequently altered genes were pTERT (63.6%), CDKN2A (39.7%), CDKN2B (38%), TP53 (33.2%), EGFR (31%), PTEN (31%), and IDH1 (20.7%). In all gliomas, alterations more frequent in smokers were TP53 (40.7% vs 26.9%, p=0.036, adjusted p=0.3) and RB1 (11.1% vs 0%, p<0.0009, adjusted p=0.02). In GBM, alterations in RB1 were more frequent in smokers (14.3% vs 0%, p<0.0051, adjusted p=0.14). In astrocytoma, TP53 alterations were more common in smokers (64.7% vs 29.2%, p=0.05, adjusted p=0.42). No differences were seen in oligodendroglioma. Median OS was shorter for smokers (46 vs 141 months, p=0.001) with 42% greater risk of death (HR 1.42, 95%CI 1.01–1.99, p=0.001), controlling for age and glioma diagnosis. 
Smokers have shorter survival from glioma. Differences in age and smoking-related genomic alterations may contribute to shortened survival.
Authors/Disclosures
Julia M. Landry
PRESENTER 		Ms. Landry has nothing to disclose.
Gabriella M. Bognet, Other Ms. Bognet has nothing to disclose.
Sarah Ahr No disclosure on file
Shakti Ramkissoon No disclosure on file
Michael Chan No disclosure on file
Christina Cramer No disclosure on file
Stephen B. Tatter, MD (Wake Forest Univ School of Medicine) The institution of Dr. Tatter has received research support from Monteris Medical, Inc. The institution of Dr. Tatter has received research support from Arbor Pharmaceuticals. Dr. Tatter has received intellectual property interests from a discovery or technology relating to health care.
Adrian Laxton No disclosure on file
Jaclyn White No disclosure on file
Ryan Mott No disclosure on file
Kimberly Stogner (ATRIUM) No disclosure on file
Eric Severson (Labcorp) No disclosure on file
Zachary Wallen (Labcorp) No disclosure on file
Fang-Chi Hsu No disclosure on file
Glenn Lesser No disclosure on file
Roy E. Strowd III, MD, FAAN (Wake Forest School Of Medicine) Dr. Strowd has received personal compensation for serving as an employee of Kaplan. Dr. Strowd has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Monteris Medical, Inc. Dr. Strowd has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novocure. The institution of Dr. Strowd has received personal compensation in the range of $500-$4,999 for serving as a Consultant for SpringWorks . Dr. Strowd has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for 好色先生. The institution of Dr. Strowd has received research support from Southeastern Brain Tumor Foundation. The institution of Dr. Strowd has received research support from Jazz Pharmaceuticals. The institution of Dr. Strowd has received research support from National Institutes of Health. The institution of Dr. Strowd has received research support from Alpha Omega Alpha. The institution of Dr. Strowd has received research support from American Board of Psychiatry and Neurology. Dr. Strowd has received publishing royalties from a publication relating to health care. Dr. Strowd has received publishing royalties from a publication relating to health care.