The prognostic value of MGMT promoter methylation in glioblastoma: A meta-analysis of clinical trials.
Maryam Moradi BinabajAfsane BahramiSoodabeh ShahidSalesMarjan JoodiMona Joudi MashhadSeyed Mahdi HassanianKazem AnvariSoodabeh ShahidsalesPublished in: Journal of cellular physiology (2017)
The DNA repair protein O6-Methylguanine-DNA methyltransferase (MGMT) is suggested to be associated with resistance to alkylating agents such as Temozolomide which is being used in treatment of patients with glioblastoma (GBM). Therefore, we evaluated the associations between MGMT promoter methylation and prognosis of patients with glioblastoma (GBM). Data were extracted from publications in Embase, PubMed, and the Cochrane Library. Data on overall survival (OS), progression-free survival (PFS), and MGMT methylation status were obtained and 4,097 subjects were enrolled. Data from 34 studies showed that MGMT methylated patients had better OS, compared to GBM unmethylated patients (pooled HRs, 0.494; 95%CI 0.412-0.591; p = 0.001). Meta-analysis of 10 eligible studies reporting on PFS, demonstrated that MGMT promoter methylation was not significantly associated with better PFS (pooled HRs, 0.653; 95%CI 0.414-1.030; p = 0.067). GBM patients with MGMT methylation were associated with longer overall survival, although this effect was not detected for PFS. Moreover, we performed further analysis in patients underwent a comprehensive imaging evaluation. This data showed a significant association with better OS and PFS, although further studies are warranted to assess the value of emerging marker in prospective setting in patients with glioblastoma as a risk stratification biomarker in clinical management of the patients.
Keyphrases
- end stage renal disease
- dna methylation
- newly diagnosed
- ejection fraction
- chronic kidney disease
- clinical trial
- prognostic factors
- peritoneal dialysis
- emergency department
- dna repair
- electronic health record
- randomized controlled trial
- free survival
- transcription factor
- mass spectrometry
- adverse drug
- deep learning
- oxidative stress
- phase iii
- smoking cessation
- patient reported
- dna damage response
- fluorescence imaging
- replacement therapy
- cell free