Lack of Benefit of Extending Temozolomide Treatment in Patients with High Vascular Glioblastoma with Methylated <i>MGMT</i>

In this study, we evaluated the benefit on survival of the combination of methylation of O6-methylguanine-DNA methyltransferase (<i>MGMT</i>) promotor gene and moderate vascularity in glioblastoma using a retrospective dataset of 123 patients from a multicenter cohort. MRI processing and...

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Autores principales:	María del Mar Álvarez-Torres, Elies Fuster-García, Carmen Balaña, Josep Puig, Juan M. García-Gómez
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	glioblastoma <i>MGMT</i> methylation tumor vascularity chemotherapy adjuvant temozolomide temozolomide cycles Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/e03182da8c724756bdbef0356b366f8e
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spelling	oai:doaj.org-article:e03182da8c724756bdbef0356b366f8e2021-11-11T15:30:58ZLack of Benefit of Extending Temozolomide Treatment in Patients with High Vascular Glioblastoma with Methylated <i>MGMT</i>10.3390/cancers132154202072-6694https://doaj.org/article/e03182da8c724756bdbef0356b366f8e2021-10-01T00:00:00Zhttps://www.mdpi.com/2072-6694/13/21/5420https://doaj.org/toc/2072-6694In this study, we evaluated the benefit on survival of the combination of methylation of O6-methylguanine-DNA methyltransferase (<i>MGMT</i>) promotor gene and moderate vascularity in glioblastoma using a retrospective dataset of 123 patients from a multicenter cohort. MRI processing and calculation of relative cerebral blood volume (rCBV), used to define moderate- and high-vascular groups, were performed with the automatic ONCOhabitats method. We assessed the previously proposed rCBV threshold (10.7) and the new calculated ones (9.1 and 9.8) to analyze the association with survival for different populations according to vascularity and <i>MGMT</i> methylation status. We found that patients included in the moderate-vascular group had longer survival when <i>MGMT</i> is methylated (significant median survival difference of 174 days, <i>p</i> = 0.0129*). However, we did not find significant differences depending on the <i>MGMT</i> methylation status for the high-vascular group (<i>p</i> = 0.9119). In addition, we investigated the combined correlation of <i>MGMT</i> methylation status and rCBV with the prognostic effect of the number of temozolomide cycles, and only significant results were found for the moderate-vascular group. In conclusion, there is a lack of benefit of extending temozolomide treatment for patients with high vascular glioblastomas, even presenting <i>MGMT</i> methylation. Preliminary results suggest that patients with moderate vascularity and methylated <i>MGMT glioblastomas</i> would benefit more from prolonged adjuvant chemotherapy.María del Mar Álvarez-TorresElies Fuster-GarcíaCarmen BalañaJosep PuigJuan M. García-GómezMDPI AGarticleglioblastoma<i>MGMT</i> methylationtumor vascularitychemotherapyadjuvant temozolomidetemozolomide cyclesNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENCancers, Vol 13, Iss 5420, p 5420 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	glioblastoma <i>MGMT</i> methylation tumor vascularity chemotherapy adjuvant temozolomide temozolomide cycles Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	glioblastoma <i>MGMT</i> methylation tumor vascularity chemotherapy adjuvant temozolomide temozolomide cycles Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 María del Mar Álvarez-Torres Elies Fuster-García Carmen Balaña Josep Puig Juan M. García-Gómez Lack of Benefit of Extending Temozolomide Treatment in Patients with High Vascular Glioblastoma with Methylated <i>MGMT</i>
description	In this study, we evaluated the benefit on survival of the combination of methylation of O6-methylguanine-DNA methyltransferase (<i>MGMT</i>) promotor gene and moderate vascularity in glioblastoma using a retrospective dataset of 123 patients from a multicenter cohort. MRI processing and calculation of relative cerebral blood volume (rCBV), used to define moderate- and high-vascular groups, were performed with the automatic ONCOhabitats method. We assessed the previously proposed rCBV threshold (10.7) and the new calculated ones (9.1 and 9.8) to analyze the association with survival for different populations according to vascularity and <i>MGMT</i> methylation status. We found that patients included in the moderate-vascular group had longer survival when <i>MGMT</i> is methylated (significant median survival difference of 174 days, <i>p</i> = 0.0129*). However, we did not find significant differences depending on the <i>MGMT</i> methylation status for the high-vascular group (<i>p</i> = 0.9119). In addition, we investigated the combined correlation of <i>MGMT</i> methylation status and rCBV with the prognostic effect of the number of temozolomide cycles, and only significant results were found for the moderate-vascular group. In conclusion, there is a lack of benefit of extending temozolomide treatment for patients with high vascular glioblastomas, even presenting <i>MGMT</i> methylation. Preliminary results suggest that patients with moderate vascularity and methylated <i>MGMT glioblastomas</i> would benefit more from prolonged adjuvant chemotherapy.
format	article
author	María del Mar Álvarez-Torres Elies Fuster-García Carmen Balaña Josep Puig Juan M. García-Gómez
author_facet	María del Mar Álvarez-Torres Elies Fuster-García Carmen Balaña Josep Puig Juan M. García-Gómez
author_sort	María del Mar Álvarez-Torres
title	Lack of Benefit of Extending Temozolomide Treatment in Patients with High Vascular Glioblastoma with Methylated <i>MGMT</i>
title_short	Lack of Benefit of Extending Temozolomide Treatment in Patients with High Vascular Glioblastoma with Methylated <i>MGMT</i>
title_full	Lack of Benefit of Extending Temozolomide Treatment in Patients with High Vascular Glioblastoma with Methylated <i>MGMT</i>
title_fullStr	Lack of Benefit of Extending Temozolomide Treatment in Patients with High Vascular Glioblastoma with Methylated <i>MGMT</i>
title_full_unstemmed	Lack of Benefit of Extending Temozolomide Treatment in Patients with High Vascular Glioblastoma with Methylated <i>MGMT</i>
title_sort	lack of benefit of extending temozolomide treatment in patients with high vascular glioblastoma with methylated <i>mgmt</i>
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/e03182da8c724756bdbef0356b366f8e
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Lack of Benefit of Extending Temozolomide Treatment in Patients with High Vascular Glioblastoma with Methylated <i>MGMT</i>

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