MGMT methylation may benefit overall survival in patients with moderately vascularized glioblastomas.
MGMT methylation may benefit overall survival in patients with moderately vascularized glioblastomas.
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MGMT甲基化可能有益于中度血管化胶质母细胞瘤患者的总生存期。
DOI：
10.1007/s00330-020-07297-4
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发表时间：
2021-03
影响因子：
5.9
通讯作者：
García-Gómez JM
中科院分区：
文献类型：
--
作者：
Fuster-Garcia E;Lorente Estellés D;Álvarez-Torres MDM;Juan-Albarracín J;Chelebian E;Rovira A;Acosta CA;Pineda J;Oleaga L;Mollá-Olmos E;Filice S;Due-Tønnessen P;Meling TR;Emblem KE;García-Gómez JM
评估肿瘤血管分布（根据灌注MRI估计）和MGMT甲基化状态对胶质母细胞瘤患者总生存期（OS）的联合作用。使用包括来自NCT 03439332临床研究的96名患者的多中心国际数据集来研究MGMT和灌注标志物之间的预后关系。使用ONCOhabitats在线分析服务从术前MRI自动获得血管化最多的肿瘤区域的相对脑血容量（rCBV）。进行考克斯生存回归模型和分层策略以定义在OS方面特别受MGMT甲基化青睐的亚群。rCBV分布在甲基化和非甲基化亚群中没有显著差异（p > 0.05）。在中度血管化肿瘤患者（rCBV < 10.73）中，MGMT甲基化是OS的阳性预测因子（HR = 2.73，p = 0.003，AUC = 0.70）。然而，在高度血管化肿瘤患者（rCBV > 10.73）中，MGMT甲基化没有显著影响（HR = 1.72，p = 0.10，AUC = 0.56）。我们的研究结果表明，MGMT甲基化和rCBV提供的互补预后信息的存在。灌注标记物可以识别从MGMT甲基化中获益最多的患者亚群。不考虑这些信息可能会导致临床研究解释中的偏倚。· MRI灌注为MGMT甲基化提供了补充的预后信息。· MGMT甲基化改善具有中等血管特征的胶质母细胞瘤患者的预后。·不考虑这些关系可能会导致临床研究解释中的偏倚。本文的在线版本（10.1007/s 00330 -020-07297-4）包含补充材料，可供授权用户使用。
To assess the combined role of tumor vascularity, estimated from perfusion MRI, and MGMT methylation status on overall survival (OS) in patients with glioblastoma. 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. 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). 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. • 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. The online version of this article (10.1007/s00330-020-07297-4) contains supplementary material, which is available to authorized users.
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