Glioblastomas (GBMs) are all too deadly cancers that often result from the progression of tumors that were initially diagnosed as lower-grade lesions.1 One of the signature genetic alterations in lower-grade gliomas is the isocitrate dehydrogenase-1 (IDH1) mutation. To date, the genetic underpinnings of malignant transformation of grade 2 and 3 gliomas are not well understood. In their recent report, Bai et al2conceived a remarkably simple study design whereby complex genetic analyses were performed on low-grade precursor tumors and their resultant, matched secondary GBMs were collected after progression in the same patients that were sometimes collected a decade later. These investigators hypothesized that comparison of matched IDH1-mutant tumors before and after progression to GBM could elucidate the genetic targets, leading to progression and targets for novel treatments. . .
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