Posttreatment Effect of MGMT Methylation Level on Glioblastoma Survival.

Abstract:

:The DNA repair protein O6-methylguanine-DNA methyltransferase (MGMT) removes temozolomide-induced alkylation, thereby preventing DNA damage and cytotoxicity. We investigated the prognostic effect of different MGMT methylation levels on overall and progression-free survival in 327 patients with primary glioblastoma undergoing standard treatment. We obtained MGMT methylation level in 4 CpG sites using pyrosequencing. The association between MGMT methylation level and survival was investigated using Cox proportional hazards model and an extension to detect time-varying effects. We found an association between MGMT methylation level and overall survival (OS) from around 9 months after the diagnosis, with no association between MGMT methylation level and OS before that. For patients surviving at least 9 months even small increases in MGMT methylation level are significantly beneficial (HR = 0.97, 95% CI [0.96, 0.98]). The predictive ability of MGMT methylation level on OS from 9 months after diagnosis has a Harrel's C of 66%. We conclude that the MGMT methylation level is strongly associated with survival only for patients surviving beyond 9 months with considerable effects for levels much lower than previously reported. Prognostic evaluation of cut-points of MGMT methylation levels and of CpG island site selection should take the time-varying effect on overall survival into account.

authors

Dahlrot RH,Larsen P,Boldt HB,Kreutzfeldt MS,Hansen S,Hjelmborg JB,Kristensen BW

doi

10.1093/jnen/nlz032

subject

Has Abstract

pub_date

2019-07-01 00:00:00

pages

633-640

issue

7

eissn

0022-3069

issn

1554-6578

pii

5486005

journal_volume

78

pub_type

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