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  • 2017년 04월호
    [Radiother Oncol.] Novel recursive partitioning analysis classification for newly diagnosed glioblastoma: A multi-institutional study highlighting the MGMT promoter methylation and IDH1 gene mutation status.

    연세의대, 서울의대 / 위찬우, 김은지, 서창옥*, 김일한*

  • 출처
    Radiother Oncol.
  • 등재일
    2017 Apr
  • 저널이슈번호
    123(1):106-111. doi: 10.1016/j.radonc.2017.02.014. Epub 2017 Mar 13.
  • 내용

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    Abstract

     

    BACKGROUND AND PURPOSE:

    To refine the recursive partitioning analysis (RPA) classification for glioblastoma incorporating the MGMT methylation and IDH1 mutation status.

     

    METHODS AND MATERIALS:

    Three-hundred forty patients were treated with radiotherapy plus concurrent and adjuvant temozolomide in three tertiary-referral hospitals. MGMT methylation and IDH1 mutation status were available in all patients. Methylation of the MGMT (MGMTmeth) and mutation of IDH1 (IDH1mut) were observed in 42.4% and 6.2% of the patients, respectively.

     

    RESULTS:

    The median follow-up for survivors and all patients was 33.2 and 20.5months, respectively. The median survival (MS) was 23.6months. RPA was performed on behalf of the results of the Cox proportional hazards model. MGMT methylation generated the initial partition (MGMTmeth vs. MGMTunmeth) in the RPA. Three final RPA classes were identified; class I=MGMTmeth/IDH1mut or MGMTmeth/IDH1wt/GTR/KPS≥90 (MS, 67.2months); class II=MGMTmeth/IDH1wt/GTR/KPS<90, MGMTmeth/IDH1wt/residual disease, MGMTunmeth/age<50, or MGMTunmeth/age≥50/GTR (MS, 24.0months); class III=MGMTunmeth/age≥50/residual disease (MS, 15.2months).

     

    CONCLUSIONS:

    A novel RPA classification for glioblastoma was formulated highlighting the impact of MGMTmeth and IDH1mut in the temozolomide era. This model integrating pertinent molecular information can be used effectively for the patient stratification in future clinical trials. An external validation is ongoing.​ 

     

    Author information

    Wee CW1, Kim E1, Kim N2, Kim IA1, Kim TM3, Kim YJ3, Park CK4, Kim JW4, Kim CY4, Choi SH5, Kim JH5, Park SH6, Choe G6, Lee ST7, Chang JH8, Kim SH9, Suh CO10, Kim IH11.

    1 Department of Radiation Oncology, Seoul National University College of Medicine, Republic of Korea.

    2 Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Republic of Korea.

    3 Department of Internal Medicine, Seoul National University College of Medicine, Republic of Korea.

    4 Department of Neurosurgery, Seoul National University College of Medicine, Republic of Korea.

    5 Department of Radiology, Seoul National University College of Medicine, Republic of Korea.

    6 Department of Pathology, Seoul National University College of Medicine, Republic of Korea.

    7 Department of Neurology, Seoul National University College of Medicine, Republic of Korea.

    8 Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Republic of Korea.

    9 Department of Pathology, Yonsei University College of Medicine, Seoul, Republic of Korea.

    10 Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address: cosuh317@yuhs.ac.

    11 Department of Radiation Oncology, Seoul National University College of Medicine, Republic of Korea. Electronic address: ihkim@snu.ac.kr. 

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