Clinical neurology and neurosurgeryOct 21, 2016

IDH mutation and MGMT methylation linked to treatment-related tumor changes and better outcomes in glioblastoma patients receiving combined chemotherapy and radiation

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Updated Apr 3, 2026

Abstract

Of the 157 glioblastoma multiforme patients, 92.36% were followed for six to 56 months.

Patients with pseudoprogression (psPD) showed a higher rate of MGMT promoter methylation and IDH1 mutation compared to those with early progression (ePD).
MGMT promoter methylation and IDH1 mutation predicted a high likelihood of developing psPD in glioblastoma patients.
Factors such as MGMT promoter methylation, IDH1 mutation, and a Karnofsky performance score (KPS) of 70 or higher were linked to significantly longer overall survival.
Patients with psPD experienced a median survival of 39.2 months, longer than those with ePD (11.9 months) or non-progression (24.4 months).
Both MGMT promoter methylation and IDH1 mutation had a cumulative positive effect on overall survival in glioblastoma patients.

Simplified

PURPOSE: This study aimed to investigate the potential association between IDH mutation and O-methyl-guanine methyl transferase (MGMT) gene promoter methylation and pseudoprogression disease (psPD) in glioblastoma multiforme (GBM) patients after concurrent temozolomide (TMZ)-based chemoradiotherapy. 6

METHODS: A total of 157 GBM patients who received concurrent TMZ-based chemoradiotherapy were included in this retrospective study. The association between psPD and a number of demographic and genetic factors, including IDH mutation and MGMT promoter methylation, were analyzed based on logistic regression, Cox regression, and multivariate analysis.

RESULTS: Of the 157 GBM patients, 145 (92.36%) patients, including 38 patients with psPD, 38 patients with early progression (ePD), and 69 patients with non-progression (non-PD), were followed up for six to 56 months. We identified a higher rate of MGMT promoter methylation and IDH1 mutation in psPD patients compared with ePD patients (P=0.002). In addition, MGMT promoter methylation and IDH1 mutation predicted a high probability of psPD development in GBM patients (P=0.001 and P<0.001, respectively). MGMT promoter methylation, IDH1 mutation, Karnofsky performance score (KPS) ≥70, and psPD were associated with a significantly longer overall survival of GBM patients (P=0.001, 0.001, 0.002, and P<0.001, respectively). Both of MGMT promoter methylation and IDH mutation had a cumulative effect on the OS of GBM patients. GBM patients with psPD (39.2±2.1months, P<0.001) had a longer median survival (MS) than GBM patients with ePD (11.9±1.1months) or with non-PD (24.4±2.4months).

CONCLUSION: MGMT promoter methylation and IDH1 mutation were associated with PsPD and predicted a longer median survival in GBM patients after TMZ-based chemoradiotherapy. Genetic analyses of the MGMT promoter and IDH1 may allow us to effectively treat GBM patients.

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IDH mutation and MGMT methylation linked to treatment-related tumor changes and better outcomes in glioblastoma patients receiving combined chemotherapy and radiation

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