Researchers have identified two genetic mutations that control the growth and development of some malignant and difficult to treat types of brain tumors.

With this discovery the chances of being able to distinguish between two subtypes of particularly deadly type of brain tumors known as gliomas, called primary and secondary glioblastoma multiforme and perhaps find a way to treat the cancers, could emerge.

Dr. Hai Yan, an assistant professor of pathology at Duke University, in Durham, N. C. and lead author of the study published in the Feb.
19 issue of the New England Journal of Medicine said these findings "open a completely new avenue" to better treatments for one of the most deadly forms of cancer and may also predict which patients will live longer.

He added that although the research does not appear to yield immediate benefits for patients but in the long run it may allow physicians to "understand what kind of tumor patients have and give them the right treatment."

Gliomas are said to affect 10,000 Americans every year, with Senator Edward Kennedy being one, and the prognosis is not promising. While this deadly form of cancer does not spread to other parts of the body it attacks the brain and can cause death within months.

Surgery is the only option as chemotherapy and radiation can damage healthy brain tissue and only allow patients to live a few months longer. Yan said, although surgery is an option, gliomas generally spread in the brain the way roots spread from a plant. It is very difficult to completely remove the tumors."

The mutations known as IDH1 or IDH2 gave patients a survival rate of an average of 31 months as compared to 15 months for glioblastoma patients whose tumors lacked either mutation. "All GBMs are basically considered the same and are treated in the same way. Our studies clearly demonstrate that we need to start thinking about them as different," said Yan in a statement. "The results are so clear cut. I have been doing intensive genetic studies in brain cancers for six years, and I have never seen gene mutations as striking as in this study."

The researchers based their findings on samples from 445 brain tumors that were compared with 494 cancers from outside the nervous system. In the IDH1 gene, a mutation was found in more than 70 percent of three common types of gliomas: low-grade astrocytomas, oligodendrogliomas, and secondary glioblastomas.

"You could use these genes to distinguish a subtype of glioma," Yan said. "Two tumors may look like a duck and walk like a duck, but the two tumors may be quite different." He added that in the future once the test determines what kind of glioma they are dealing with, doctors can choose from a variety of treatment options. "You can give one kind of patients one kind of drug, and others another kind of drug," Yan said.

Till treatment reaches this stage, Yan said a genetic test that costs under $100 could provide important information about the patients prognosis by revealing the type of tumor they have.