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Open Access 01-03-2021 | Glioblastoma | Oncology

MGMT methylation may benefit overall survival in patients with moderately vascularized glioblastomas

Authors: Elies Fuster-Garcia, David Lorente Estellés, María del Mar Álvarez-Torres, Javier Juan-Albarracín, Eduard Chelebian, Alex Rovira, Cristina Auger Acosta, Jose Pineda, Laura Oleaga, Enrique Mollá-Olmos, Silvano Filice, Paulina Due-Tønnessen, Torstein R. Meling, Kyrre E. Emblem, Juan M. García-Gómez

Published in: European Radiology | Issue 3/2021

Abstract

Objectives

To assess the combined role of tumor vascularity, estimated from perfusion MRI, and MGMT methylation status on overall survival (OS) in patients with glioblastoma.

Methods

A multicentric international dataset including 96 patients from NCT03439332 clinical study were used to study the prognostic relationships between MGMT and perfusion markers. Relative cerebral blood volume (rCBV) in the most vascularized tumor regions was automatically obtained from preoperative MRIs using ONCOhabitats online analysis service. Cox survival regression models and stratification strategies were conducted to define a subpopulation that is particularly favored by MGMT methylation in terms of OS.

Results

rCBV distributions did not differ significantly (p > 0.05) in the methylated and the non-methylated subpopulations. In patients with moderately vascularized tumors (rCBV < 10.73), MGMT methylation was a positive predictive factor for OS (HR = 2.73, p = 0.003, AUC = 0.70). In patients with highly vascularized tumors (rCBV > 10.73), however, there was no significant effect of MGMT methylation (HR = 1.72, p = 0.10, AUC = 0.56).

Conclusions

Our results indicate the existence of complementary prognostic information provided by MGMT methylation and rCBV. Perfusion markers could identify a subpopulation of patients who will benefit the most from MGMT methylation. Not considering this information may lead to bias in the interpretation of clinical studies.

Key Points

• MRI perfusion provides complementary prognostic information to MGMT methylation.

• MGMT methylation improves prognosis in glioblastoma patients with moderate vascular profile.

• Failure to consider these relations may lead to bias in the interpretation of clinical studies.

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Title: MGMT methylation may benefit overall survival in patients with moderately vascularized glioblastomas
Authors: Elies Fuster-Garcia
David Lorente Estellés
María del Mar Álvarez-Torres
Javier Juan-Albarracín
Eduard Chelebian
Alex Rovira
Cristina Auger Acosta
Jose Pineda
Laura Oleaga
Enrique Mollá-Olmos
Silvano Filice
Paulina Due-Tønnessen
Torstein R. Meling
Kyrre E. Emblem
Juan M. García-Gómez
Publication date: 01-03-2021
Publisher: Springer Berlin Heidelberg
Keywords: Glioblastoma
Glioblastoma
Glioblastoma
Published in: European Radiology / Issue 3/2021
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-020-07297-4

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

MGMT methylation may benefit overall survival in patients with moderately vascularized glioblastomas

Abstract

Objectives

Methods

Results

Conclusions

Key Points

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key Points

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