Assessing the Impact of MGMT Promoter Methylation as a Prognostic Marker in Patients with Glioma- A Single-Center Observational Study

Background: The MGMT gene is epigenetically silenced by promoter hypermethylation in gliomas
and this modification has emerged as a relevant predictor of therapeutic response.
The current study was aimed to correlate the methylation status of the O6 -methylguanine-DNAmethyltransferase
(MGMT promoter gene) and response to alkylating agent based treatment in high
grade gliomas
Methods: 20 cases of high grade glioma were analyzed for MGMT promoter methylation by
methylation-specific PCR. Response to treatment and overall survival was recorded and data
analysed.
Results: MGMT promoter methylation was found in 60% of gliomas by methylation-specific PCR .
The mean survival time of glioblastoma patients submitted to adjuvant therapy was significantly higher
among patients with MGMT promoter methylation (P= 0.035) and methylation status was an
independent predictive factor that was associated with improved prognosis.
Discussion and Conclusion: MGMT promoter methylation status was a more reliable predictor of
response to adjuvant therapy and prognosis of high grade gliomas. A subset of patients received
irinotecan and bevacizumab in the second line setting and patients with unmethylated MGMT seemed
to do better than the MGMT promoter methylated group.