AOS23 O6-methylguanine-DNA-methyltransferase expression in Thai patients with malignant gliomas: Outcome and response to treatment in Ramathibodi Hospital

Background Malignant glioma is a rare but fatal tumour. High expression of O6-methylguanine-DNA-methyltransferase (MGMT) has been linked to poor outcome. We investigated the frequency of MGMT expression and its correlation with outcome and response to treatment in Thai patients. Methods In a retrosp...

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Bibliographic Details
Published in:European journal of cancer (1990) Vol. 48; p. S11
Main Authors: Akwattanakul, W, Larbcharoensub, N, Rattanasiri, S, Sirachainan, E, Panvichian, R, Ativitavas, T, Ratanatharathorn, V, Sirisinha, T
Format: Journal Article
Language:English
Published: Elsevier Ltd 01-04-2012
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Summary:Background Malignant glioma is a rare but fatal tumour. High expression of O6-methylguanine-DNA-methyltransferase (MGMT) has been linked to poor outcome. We investigated the frequency of MGMT expression and its correlation with outcome and response to treatment in Thai patients. Methods In a retrospective cohort study of adult patients with histologically confirmed WHO grade III and IV malignant glioma diagnosed at Ramathibodi Hospital between January 1997 and December 2009, tumour tissue was assayed for MGMT immunohistochemistry status using MT 3.1 antibody with normal brain as the internal control. Data for clinical characteristics, treatment details, and outcome were collected. The main objective was the frequency of MGMT overexpression. Secondary outcomes were the correlation of MGMT expression with survival and treatment response. Findings One hundred thirty-five patients were eligible for analysis. The median age was 47 years. The most common histology was glioblastoma multiforme (WHO grade IV, 54.8%). Only 97 specimens were available for MGMT analysis and overexpression was detected in 31%. Median overall survival (OS) was 11.9 months and 1-year, 2-year, and 5-year OS was 50% (95% confidence interval (CI), 0.41–0.58), 34% (95% CI, 0.26–0.42), and 21% (95% CI, 0.14–0.29), respectively. Four significant adverse prognostic factors for survival that were identified in a multivariate analysis were diabetes mellitus, neurological deficit at diagnosis, histology of glioblastoma multiforme, and receipt of only single treatment modality. MGMT expression did not have prognostic value in the univariate and multivariate analyses. There was no difference in overall survival or response to treatment with temozolamide/BCNU in the subgroup with low MGMT compared with high MGMT. Interpretation The prevalence of MGMT expression in Thai patients with malignant glioma was not different from that reported elsewhere. MGMT expression did not affect outcome in this study cohort. Therefore, considering MGMT as a relevant factor in selection for treatment with temozolamide might be premature. Funding Faculty research grant from Ramathibodi Hospital. The authors declared no conflicts of interest.
ISSN:0959-8049
1879-0852
DOI:10.1016/j.ejca.2012.02.039