J Cancer 2022; 13(1):354-363. doi:10.7150/jca.63595 This issue Cite

Review

Clinical strategies to manage adult glioblastoma patients without MGMT hypermethylation

Delin Liu, Tianrui Yang, Wenbin Ma, Yu Wang

Department of Neurosurgery, Peking Union Medical College Hospital, Beijing, China.

Citation:
Liu D, Yang T, Ma W, Wang Y. Clinical strategies to manage adult glioblastoma patients without MGMT hypermethylation. J Cancer 2022; 13(1):354-363. doi:10.7150/jca.63595. https://www.jcancer.org/v13p0354.htm
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Abstract

Graphic abstract

Glioblastoma (GBM) is a highly malignant brain tumor with a dismal prognosis. Standard therapy for GBM comprises surgical resection, followed by radiotherapy plus concomitant and adjuvant temozolomide (TMZ) therapy. The methylation status of the O6-methylguanine DNA methyltransferase (MGMT) promoter is one of the most essential predictive biomarkers for patients with GBM treated with TMZ. Patients with an unmethylated MGMT promoter (umMGMT), who comprise 60% of patients with GBM, present an even worse prognosis because of TMZ resistance. Radiotherapy with various fractionation, chemotherapy compensating for TMZ, targeted therapy against diverse oncogenic pathways, immunotherapy of vaccine or immune checkpoint inhibitor, and tumor treating fields have been studied in umMGMT GBM patients. However, most efforts have yielded negative results or merely minimal improvements. Therefore, effective patient subgroup selection concerning precision medicine has become the focus. By assigning different treatments to the corresponding patient subgroups, a better curative effect and subsequently prolonged survival can be achieved. In this review, we re-evaluate the value of standard TMZ therapy and summarize the new clinical strategies and attempts to treat patients with umMGMT, which yielded positive and negative results, to provide alternative treatment options and discuss future directions of umMGMT GBM treatment.

Keywords: glioblastoma, MGMT, methylation, therapy, clinical trial


Citation styles

APA
Liu, D., Yang, T., Ma, W., Wang, Y. (2022). Clinical strategies to manage adult glioblastoma patients without MGMT hypermethylation. Journal of Cancer, 13(1), 354-363. https://doi.org/10.7150/jca.63595.

ACS
Liu, D.; Yang, T.; Ma, W.; Wang, Y. Clinical strategies to manage adult glioblastoma patients without MGMT hypermethylation. J. Cancer 2022, 13 (1), 354-363. DOI: 10.7150/jca.63595.

NLM
Liu D, Yang T, Ma W, Wang Y. Clinical strategies to manage adult glioblastoma patients without MGMT hypermethylation. J Cancer 2022; 13(1):354-363. doi:10.7150/jca.63595. https://www.jcancer.org/v13p0354.htm

CSE
Liu D, Yang T, Ma W, Wang Y. 2022. Clinical strategies to manage adult glioblastoma patients without MGMT hypermethylation. J Cancer. 13(1):354-363.

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