Temozolomide-induced hypermutation is associated with distant recurrence and reduced survival after high-grade transformation of low-grade <i>IDH</i>-mutant gliomas

Abstract

TMZ-induced hypermutation is a common event in transformed LGG previously treated with TMZ and is associated with worse prognosis and development of discontiguous disease after recurrence. These findings impact tumor classification at recurrence, prognostication, and clinical trial design.