在1p19q-完好无损的质瘤中MGMT促进剂甲基化
Connor J Kinslow1,2, Markus D Siegelin2,3, Fabio M Iwamoto2,4
1Department of Radiation Oncology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, 622 West 168th Street, BNH B011, New York, NY, 10032, USA.
Journal of neuro-oncology
|December 19, 2023
概括
对于1p19q-完好无损的形星球细胞瘤,辅助剂temozolomide (TMZ) 仍然是标准的护理,无论O6-甲基瓜氨酸-DNA甲基转移酶 (MGMT) 状态如何. MGMT促进物甲基化是IDH野生型质瘤的关键因素,影响生存结果.
科学领域:
- 神经瘤学神经瘤学
- 癌症基因组学 癌症基因组学
- 临床试验分析临床试验分析
背景情况:
- 基于CATNON试验,1p19q-完好无损的质质瘤的标准护理包括辅助剂temozolomide (TMZ) 和放射治疗.
- 无论MGMT促进体状态如何,TMZ在IDH野生型质瘤中没有显示生存益处,这促使进一步调查.
- 在2-3级质瘤中MGMT状态的预后和预测作用仍然不清楚.
研究的目的:
- 为了确定MGMT促进物甲基化状态对1p19q完好无损质瘤患者的整体存活期 (OS) 的影响.
- 分析来自国家癌症数据库 (NCDB) 的数据,用于IDH野生型或IDH突变天体细胞瘤的患者.
- 为未来的IDH野生型扩散性质瘤的临床试验设计提供信息.
主要方法:
- 查询了接受化疗的扩散 (2级) 和形 (3级) IDH野生型或突变型星系细胞瘤患者的NCDB (2018-2019).
- 利用Kaplan-Meier方法和Cox比例危险回归模型来评估MGMT状态和OS之间的关联.
- 分析了数据,并追踪到2022年.
主要成果:
- 确定了1514名患者:802名IDH野生型 (33%甲基化) 和712名IDH突变 (48%甲基化) 天体细胞瘤.
- 非甲基化MGMT促进剂与IDH野生型质瘤 (3年OS34%与46%相比,p <.001,aHR1.53) 的生存率较差有关.
- 在IDH突变天体细胞瘤中没有观察到MGMT状态和OS之间的显著关联 (3年OS79%对比80%,p = .81,HR1.04).
结论:
- 支持辅助性TMZ作为对形星球细胞瘤 (IDH-突变,1p19q-完好无损) 的标准护理,无论MGMT状态如何.
- 强调需要确定IDH野生型扩散性结质瘤的最佳治疗策略.
- 建议在未来对IDH野生型质瘤的临床试验中考虑将MGMT促进物甲基化作为分层因素.
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