Role of MGMT methylation status at time of diagnosis and recurrence for patients with glioblastoma: Clinical implications

Alba A. Brandes, Enrico Franceschi, Alexandro Paccapelo, Giovanni Tallini, Dario De Biase, Claudio Ghimenton, Daniela Danieli, Elena Zunarelli, Giovanni Lanza, Enrico Maria Silini, Carmelo Sturiale, Lorenzo Volpin, Franco Servadei, Andrea Talacchi, Antonio Fioravanti, Maria Pia Foschini, Stefania Bartolini, Annalisa Pession, Mario Ermani

Research output: Contribution to journalArticlepeer-review

Abstract

Background. MGMT methylation status represents a powerful prognostic factor in newly diagnosed glioblastoma (GBM). Recently, its role in recurrent tumors has also been suggested; however, few data investigating the stability of this biomarker during the clinical course of the disease are available. In this study, we evaluated the rate of change of MGMT methylation status between diagnosis and first recurrence in patients who received tumor resection for recurrent GBM. Methods. We included patients who received temozolomide concurrent with and adjuvant to radiotherapy after diagnosis of GBM and had a second surgery performed at least 3 months after radiotherapy completion. Other eligibility criteria were age >18 years and Eastern Cooperative Oncology Group performance status 0-2.We evaluated the MGMT methylation status by methylation-specific polymerase chain reaction. Results. From our institutional data warehouse, 295 patients with recurrent GBM who underwent second surgery were evaluated. MGMT methylation status at both first and second surgery was available for 108 patients. MGMT was methylated in both surgeries in 38 patients (35.2%), while it was unmethylated in 43 patients (39.8%). We found a significant concordance between the first and the second MGMT methylation assessments (K=0.500, p <.001), MGMT methylation being stable in 75% of the cases. Conclusion. MGMT methylation presents relative stability during the clinical course of GBM.

Original languageEnglish
Pages (from-to)432-437
Number of pages6
JournalOncologist
Volume22
Issue number4
DOIs
Publication statusPublished - Apr 1 2017

Keywords

  • Glioblastoma
  • Heterogeneity
  • MGMT methylation
  • Recurrent glioblastoma
  • Surgery

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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