Abstract Details

Title TERT Promoter Mutation, Possibly an Independent High-risk Prognostic Marker in Meningioma

Topic Neuro-oncology

Presentation(s) P8 - Poster Session 8 (11:45 AM-12:45 PM)

Poster/Presentation
Number 6-002

Objective To evaluate the prognostic significance of the TERT promoter mutation (TERTp-m) in meningioma, quantifying its impact on overall survival and exploring the sources of heterogeneity through Bayesian meta-analysis methods.

Background The prognostic role of TERTp-m in meningioma remains controversial, with inconsistent findings across studies. Understanding the mutation’s influence on survival and its interplay with clinical and molecular factors is critical for risk stratification.

Design/Methods Nine studies including diverse meningioma cohorts were analyzed. Data on hazard ratios (HR) for survival were extracted and processed. A Bayesian random-effects meta-analysis was performed using weakly informative priors. Meta-regressions explored associations with WHO tumor grade and other covariates.
The primary outcome was the pooled HR for overall survival of TERTp-m versus wild-type. Secondary analyses assessed heterogeneity (I²), between-study variance (τ), and predictive probabilities of clinically relevant effect sizes. Language refinement was assisted by ChatGPT (OpenAI, GPT-5).

Results The pooled median HR was 2.09 (95% credible interval: 1.27–3.60), indicating that TERTp-m patients had approximately twice the risk of death compared to wild-type. The heterogeneity was moderate (τ = 0.48, I² ≈ 46%), suggesting variability among studies. Meta-regression showed that WHO Grade II tumor percentage significantly explained heterogeneity in effect sizes, while age and sex had no significant influence. The predictive probability that the true effect exceeds a 50% increase in hazard (HR>1.5) was high (~81%), confirming the clinical relevance of TERTp-m status.

Conclusions TERT promoter mutation is a significant independent adverse prognostic factor in meningioma, associated with a two-fold increased hazard of death. The mutation’s impact is largely moderated by the proportion of WHO Grade II tumors in the study populations. This evidence supports incorporating TERTp-m status into clinical prognostic models and highlights the importance of tumor grade in interpreting mutation effects.

Authors/Disclosures
Aman Bakhsh, MBBS PRESENTER	Dr. Bakhsh has nothing to disclose.
Fatima Sajid, MBBS	Miss Sajid has nothing to disclose.
Prateek Thakur (ALL INDIA INSTITUTE OF MEDICAL SCIENCES)	Mr. Thakur has nothing to disclose.
Akash Rawat, MD, MBBS	Dr. Rawat has nothing to disclose.
Bavesh Siva, MD	Dr. Siva has nothing to disclose.
Aayush Patel	Mr. Patel has nothing to disclose.
Romil Kukadiya, MBBS (Pramukhswami Medical College)	Dr. Kukadiya has nothing to disclose.

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