Correlation of tumor O6 methylguanine-DNA methyltransferase levels with survival of malignant astrocytoma patients treated with bis- chloroethylnitrosourea: A Southwest Oncology Group study

Kurt Jaeckle, Harmon J. Eyre, Jeannette J. Townsend, Susan Schulman, Heidi M. Knudson, Michael Belanich, Daniel B. Yarosh, Scott I. Bearman, Dori J. Giroux, S. Clifford Schold

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Abstract

Purpose: Prior studies show that increased levels of the DNA repair protein O6 methylguanine-DNA methyltransferase (MGMT), also referred to as O6-alkylguanine-DNA alkyltransferase (AGT) correlate with the resistance of glioma cell lines to nitrosoureas. The observed nitrosourea sensitivity of MGMT-deficient lines (methyl excision repair negative [MER-]) and those repair-proficient lines pretreated with MGMT-specific inhibitors (eg, 06 benzylguanine) has raised the possibility that tumor MGMT levels may be an important predictor of survival in patients with gliomas. Patients and Methods: We correlated the MGMT level in malignant astrocytoma tissues, obtained from patients treated with radiotherapy and bis- chloroethylnitrosourea (BCNU) on a prior prospective trial (Southwest Oncology Group [SWAG] 8737), with overall and failure-free survival. Results: Of 64 assessable patients with malignant astrocytoma (63% glioblastoma, 37% anaplastic astrocytoma), 64% had high (> 60,000 molecules/nucleus) MGMT levels. The overall median survival for patients with high versus low MGMT levels was 8 and 29 months, respectively (P = .0002), and median failure- free survival 3 and 6 months, respectively (P = .008). Subset analysis by histology (high v low MGMT levels) for anaplastic astrocytoma was 14 versus 62 months (n = 24) and for glioblastoma was 7 versus 12 months (n = 40). The overall hazards ratio (risk for death) for high versus low MGMT levels was 3.41; in young patients, the hazards ratio was higher (age 18 to 40 years, 4.19; age 41 to 60 years, 3.08) but became equal by MGMT level at age older than 60 years (1.11). Multivariate analysis showed that MGMT was independent of other known prognostic factors (age, performance status, histology). Conclusion: The MGMT level in tumor tissue specimens may be a predictive marker of survival in patients with malignant astrocytoma that is independent of other previously described prognostic variables.

Original languageEnglish (US)
Pages (from-to)3310-3315
Number of pages6
JournalJournal of Clinical Oncology
Volume16
Issue number10
DOIs
StatePublished - Jan 1 1998

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Astrocytoma
Methyltransferases
Survival
DNA
Neoplasms
Glioblastoma
Glioma
DNA Repair
O-(6)-methylguanine
Histology
Radiotherapy
Multivariate Analysis
Odds Ratio

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Jaeckle, Kurt ; Eyre, Harmon J. ; Townsend, Jeannette J. ; Schulman, Susan ; Knudson, Heidi M. ; Belanich, Michael ; Yarosh, Daniel B. ; Bearman, Scott I. ; Giroux, Dori J. ; Schold, S. Clifford. / Correlation of tumor O6 methylguanine-DNA methyltransferase levels with survival of malignant astrocytoma patients treated with bis- chloroethylnitrosourea : A Southwest Oncology Group study. In: Journal of Clinical Oncology. 1998 ; Vol. 16, No. 10. pp. 3310-3315.
@article{c62fe183384a4f10b45243c1aa58433b,
title = "Correlation of tumor O6 methylguanine-DNA methyltransferase levels with survival of malignant astrocytoma patients treated with bis- chloroethylnitrosourea: A Southwest Oncology Group study",
abstract = "Purpose: Prior studies show that increased levels of the DNA repair protein O6 methylguanine-DNA methyltransferase (MGMT), also referred to as O6-alkylguanine-DNA alkyltransferase (AGT) correlate with the resistance of glioma cell lines to nitrosoureas. The observed nitrosourea sensitivity of MGMT-deficient lines (methyl excision repair negative [MER-]) and those repair-proficient lines pretreated with MGMT-specific inhibitors (eg, 06 benzylguanine) has raised the possibility that tumor MGMT levels may be an important predictor of survival in patients with gliomas. Patients and Methods: We correlated the MGMT level in malignant astrocytoma tissues, obtained from patients treated with radiotherapy and bis- chloroethylnitrosourea (BCNU) on a prior prospective trial (Southwest Oncology Group [SWAG] 8737), with overall and failure-free survival. Results: Of 64 assessable patients with malignant astrocytoma (63{\%} glioblastoma, 37{\%} anaplastic astrocytoma), 64{\%} had high (> 60,000 molecules/nucleus) MGMT levels. The overall median survival for patients with high versus low MGMT levels was 8 and 29 months, respectively (P = .0002), and median failure- free survival 3 and 6 months, respectively (P = .008). Subset analysis by histology (high v low MGMT levels) for anaplastic astrocytoma was 14 versus 62 months (n = 24) and for glioblastoma was 7 versus 12 months (n = 40). The overall hazards ratio (risk for death) for high versus low MGMT levels was 3.41; in young patients, the hazards ratio was higher (age 18 to 40 years, 4.19; age 41 to 60 years, 3.08) but became equal by MGMT level at age older than 60 years (1.11). Multivariate analysis showed that MGMT was independent of other known prognostic factors (age, performance status, histology). Conclusion: The MGMT level in tumor tissue specimens may be a predictive marker of survival in patients with malignant astrocytoma that is independent of other previously described prognostic variables.",
author = "Kurt Jaeckle and Eyre, {Harmon J.} and Townsend, {Jeannette J.} and Susan Schulman and Knudson, {Heidi M.} and Michael Belanich and Yarosh, {Daniel B.} and Bearman, {Scott I.} and Giroux, {Dori J.} and Schold, {S. Clifford}",
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Correlation of tumor O6 methylguanine-DNA methyltransferase levels with survival of malignant astrocytoma patients treated with bis- chloroethylnitrosourea : A Southwest Oncology Group study. / Jaeckle, Kurt; Eyre, Harmon J.; Townsend, Jeannette J.; Schulman, Susan; Knudson, Heidi M.; Belanich, Michael; Yarosh, Daniel B.; Bearman, Scott I.; Giroux, Dori J.; Schold, S. Clifford.

In: Journal of Clinical Oncology, Vol. 16, No. 10, 01.01.1998, p. 3310-3315.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Correlation of tumor O6 methylguanine-DNA methyltransferase levels with survival of malignant astrocytoma patients treated with bis- chloroethylnitrosourea

T2 - A Southwest Oncology Group study

AU - Jaeckle, Kurt

AU - Eyre, Harmon J.

AU - Townsend, Jeannette J.

AU - Schulman, Susan

AU - Knudson, Heidi M.

AU - Belanich, Michael

AU - Yarosh, Daniel B.

AU - Bearman, Scott I.

AU - Giroux, Dori J.

AU - Schold, S. Clifford

PY - 1998/1/1

Y1 - 1998/1/1

N2 - Purpose: Prior studies show that increased levels of the DNA repair protein O6 methylguanine-DNA methyltransferase (MGMT), also referred to as O6-alkylguanine-DNA alkyltransferase (AGT) correlate with the resistance of glioma cell lines to nitrosoureas. The observed nitrosourea sensitivity of MGMT-deficient lines (methyl excision repair negative [MER-]) and those repair-proficient lines pretreated with MGMT-specific inhibitors (eg, 06 benzylguanine) has raised the possibility that tumor MGMT levels may be an important predictor of survival in patients with gliomas. Patients and Methods: We correlated the MGMT level in malignant astrocytoma tissues, obtained from patients treated with radiotherapy and bis- chloroethylnitrosourea (BCNU) on a prior prospective trial (Southwest Oncology Group [SWAG] 8737), with overall and failure-free survival. Results: Of 64 assessable patients with malignant astrocytoma (63% glioblastoma, 37% anaplastic astrocytoma), 64% had high (> 60,000 molecules/nucleus) MGMT levels. The overall median survival for patients with high versus low MGMT levels was 8 and 29 months, respectively (P = .0002), and median failure- free survival 3 and 6 months, respectively (P = .008). Subset analysis by histology (high v low MGMT levels) for anaplastic astrocytoma was 14 versus 62 months (n = 24) and for glioblastoma was 7 versus 12 months (n = 40). The overall hazards ratio (risk for death) for high versus low MGMT levels was 3.41; in young patients, the hazards ratio was higher (age 18 to 40 years, 4.19; age 41 to 60 years, 3.08) but became equal by MGMT level at age older than 60 years (1.11). Multivariate analysis showed that MGMT was independent of other known prognostic factors (age, performance status, histology). Conclusion: The MGMT level in tumor tissue specimens may be a predictive marker of survival in patients with malignant astrocytoma that is independent of other previously described prognostic variables.

AB - Purpose: Prior studies show that increased levels of the DNA repair protein O6 methylguanine-DNA methyltransferase (MGMT), also referred to as O6-alkylguanine-DNA alkyltransferase (AGT) correlate with the resistance of glioma cell lines to nitrosoureas. The observed nitrosourea sensitivity of MGMT-deficient lines (methyl excision repair negative [MER-]) and those repair-proficient lines pretreated with MGMT-specific inhibitors (eg, 06 benzylguanine) has raised the possibility that tumor MGMT levels may be an important predictor of survival in patients with gliomas. Patients and Methods: We correlated the MGMT level in malignant astrocytoma tissues, obtained from patients treated with radiotherapy and bis- chloroethylnitrosourea (BCNU) on a prior prospective trial (Southwest Oncology Group [SWAG] 8737), with overall and failure-free survival. Results: Of 64 assessable patients with malignant astrocytoma (63% glioblastoma, 37% anaplastic astrocytoma), 64% had high (> 60,000 molecules/nucleus) MGMT levels. The overall median survival for patients with high versus low MGMT levels was 8 and 29 months, respectively (P = .0002), and median failure- free survival 3 and 6 months, respectively (P = .008). Subset analysis by histology (high v low MGMT levels) for anaplastic astrocytoma was 14 versus 62 months (n = 24) and for glioblastoma was 7 versus 12 months (n = 40). The overall hazards ratio (risk for death) for high versus low MGMT levels was 3.41; in young patients, the hazards ratio was higher (age 18 to 40 years, 4.19; age 41 to 60 years, 3.08) but became equal by MGMT level at age older than 60 years (1.11). Multivariate analysis showed that MGMT was independent of other known prognostic factors (age, performance status, histology). Conclusion: The MGMT level in tumor tissue specimens may be a predictive marker of survival in patients with malignant astrocytoma that is independent of other previously described prognostic variables.

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