Resumen:
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[EN] Despite the complete treatment with surgery, chemotherapy and radiotherapy, patients with glioblastoma have a devasting prognosis. Although the role of extending temozolomide treatment has been explored, the results ...[+]
[EN] Despite the complete treatment with surgery, chemotherapy and radiotherapy, patients with glioblastoma have a devasting prognosis. Although the role of extending temozolomide treatment has been explored, the results are inconclusive. Recent evidence suggested that tumor vascularity may be a modulating factor in combination with methylation of O6-methylguanine-DNA methyltransferase (MGMT) promotor gene on the effect of temozolomide-based therapies, opening new possibilities for personalized treatments. Before proposing a prospective interventional clinical study, it is necessary to confirm the beneficial effect of the combined effect of MGMT methylation and moderate tumor vascularity, as well as the lack of benefit of temozolomide in patients with a highly vascular tumor.In this study, we evaluated the benefit on survival of the combination of methylation of O6-methylguanine-DNA methyltransferase (MGMT) promotor gene and moderate vascularity in glioblastoma using a retrospective dataset of 123 patients from a multicenter cohort. MRI processing and calculation of relative cerebral blood volume (rCBV), used to define moderate- and high-vascular groups, were performed with the automatic ONCOhabitats method. We assessed the previously proposed rCBV threshold (10.7) and the new calculated ones (9.1 and 9.8) to analyze the association with survival for different populations according to vascularity and MGMT methylation status. We found that patients included in the moderate-vascular group had longer survival when MGMT is methylated (significant median survival difference of 174 days, p = 0.0129*). However, we did not find significant differences depending on the MGMT methylation status for the high-vascular group (p = 0.9119). In addition, we investigated the combined correlation of MGMT methylation status and rCBV with the prognostic effect of the number of temozolomide cycles, and only significant results were found for the moderate-vascular group. In conclusion, there is a lack of benefit of extending temozolomide treatment for patients with high vascular glioblastomas, even presenting MGMT methylation. Preliminary results suggest that patients with moderate vascularity and methylated MGMT glioblastomas would benefit more from prolonged adjuvant chemotherapy.
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Código del Proyecto:
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info:eu-repo/grantAgreement/AEI/Plan Estatal de Investigación Científica y Técnica y de Innovación 2017-2020/PID2019-104978RB-I00/ES/SISTEMA DE AYUDA A LA DECISION VALIDADO CLINICAMENTE BASADO EN MODELOS DE INTELIGENCIA ARTIFICIAL A NIVEL DE PIXEL PARA DECIDIR OPCIONES TERAPEUTICAS EN GLIOBLASTOMA/
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info:eu-repo/grantAgreement/AEI/Plan Estatal de Investigación Científica y Técnica y de Innovación 2017-2020/PID2019-104978RB-I00/ES/SISTEMA DE AYUDA A LA DECISION VALIDADO CLINICAMENTE BASADO EN MODELOS DE INTELIGENCIA ARTIFICIAL A NIVEL DE PIXEL PARA DECIDIR OPCIONES TERAPEUTICAS EN GLIOBLASTOMA/
info:eu-repo/grantAgreement/Fundació La Marató de TV3//665%2FC%2F2013/
info:eu-repo/grantAgreement/EC/H2020/727560/EU
info:eu-repo/grantAgreement/South-Eastern Norway Regional Health Authority//2021057/
info:eu-repo/grantAgreement/EC/H2020/825750/EU
info:eu-repo/grantAgreement/AEI//DPI2016-80054-R//BIOMARCADORES DINAMICOS BASADOS EN FIRMAS TISULARES MULTIPARAMETRICAS PARA EL SEGUIMIENTO Y EVALUACION DE LA RESPUESTA A TRATAMIENTO DE PACIENTES CON GLIOBLASTOMA Y CANCER DE PROSTATA/
info:eu-repo/grantAgreement/EC/H2020/844646/EU
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Agradecimientos:
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M.A-T was supported by DPI2016-80054-R (Programa Estatal de Promocion del Talento y su Empleabilidad en I+D+i). This work was partially supported by the ALBATROSS project (National Plan for Scientific and Technical Research ...[+]
M.A-T was supported by DPI2016-80054-R (Programa Estatal de Promocion del Talento y su Empleabilidad en I+D+i). This work was partially supported by the ALBATROSS project (National Plan for Scientific and Technical Research and Innovation 2017-2020, No. PID2019-104978RB-I00). This study was partially funded by the Fundacio La Marato TV3 (665/C/2013) (http://www.ccma.cat/tv3/marato/projectes-financats/2012/231/ Accessed on 8th September 2021). (JMGG); H2020-SC1-2016-CNECT Project (No. 727560) (JMGG), and H2020-SC1-BHC-2018-2020 (No. 825750) (JMGG). EFG was supported by the European Unions Horizon 2020 research and innovation program under the Marie Sklodowska-Curie grant agreement No 844646 and South-Eastern Norway Regional Health Authority Grant 2021057.
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