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Medline ® Abstract for Reference 43

of 'Clinical features, pathology, and prognostic factors for oligodendroglial tumors'

43
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MGMT-STP27 methylation status as predictive marker for response to PCV in anaplastic Oligodendrogliomas and Oligoastrocytomas. A report from EORTC study 26951.
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van den Bent MJ, Erdem-Eraslan L, Idbaih A, de Rooi J, Eilers PH, Spliet WG, den Dunnen WF, Tijssen C, Wesseling P, Sillevis Smitt PA, Kros JM, Gorlia T, French PJ
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Clin Cancer Res. 2013;19(19):5513. Epub 2013 Aug 15.
 
PURPOSE: The long-term follow-up results from the EORTC-26951 trial showed that the addition of procarbazine, CCNU, and vincristine (PCV) after radiotherapy increases survival in anaplastic oligodendrogliomas/oligoastrocytomas (AOD/AOA). However, some patients appeared to benefit more from PCV treatment than others.
EXPERIMENTAL DESIGN: We conducted genome-wide methylation profiling of 115 samples included in the EORTC-26951 trial and extracted the CpG island hypermethylated phenotype (CIMP) and MGMT promoter methylation (MGMT-STP27) status.
RESULTS: We first show that methylation profiling can be conducted on archival tissues with a performance that is similar to snap-frozen tissue samples. We then conducted methylation profiling on EORTC-26951 clinical trial samples. Univariate analysis indicated that CIMP+ or MGMT-STP27 methylated tumors had an improved survival compared with CIMP- and/or MGMT-STP27 unmethylated tumors [median overall survival (OS), 1.05 vs. 6.46 years and 1.06 vs. 3.8 years, both P<0.0001 for CIMP and MGMT-STP27 status, respectively]. Multivariable analysis indicates that CIMP and MGMT-STP27 are significant prognostic factors for survival in presence of age, sex, performance score, and review diagnosis in the model. CIMP+ and MGMT-STP27 methylated tumors showed a clear benefit from adjuvant PCV chemotherapy: the median OS of CIMP+ samples in the RT and RT-PCV arms was 3.27 and 9.51 years, respectively (P = 0.0033); for MGMT-STP27 methylated samples, it was 1.98 and 8.65 years. There was no such benefit for CIMP- or for MGMT-STP27 unmethylated tumors. MGMT-STP27 status remained significant in an interaction test (P = 0.003). Statistical analysis of microarray (SAM) identified 259 novel CpGs associated with treatment response.
CONCLUSIONS: MGMT-STP27 may be used to guide treatment decisions in this tumor type.
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Authors' Affiliations: Departments of Neurology, Biostatistics, and Pathology, Neuro-Oncology Unit Erasmus MC, Rotterdam; AP-HP, Groupe Hospitalier Pitie Salpêtrière, Service de Neurologie 2 Mazarin and UniversitéPierre et Marie Curie-Paris 6, Centre de Recherche de l'Institut du Cerveau et de la Moelle Epinière (CRICM), Paris, France; Department of Pathology, UMCU, Utrecht; Department of Pathology, UMCG, Groningen; Department of Neurology, St. Elisabeth Hospital, Tilburg; Department of Pathology, Radboud University Nijmegen Medical Centre, Nijmegen; Department of Pathology, Free University Medical Center, Amsterdam, the Netherlands; and European Organization for Research and Treatment of Cancer Data Center, Brussels, Belgium.
PMID