Pseudoprogression and MGMT status in glioblastoma patients: implications in clinical practice.

Jul 15, 2009Anticancer research

Pseudoprogression and MGMT gene status in glioblastoma patients: what this means for treatment

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Circadian Biology on OpenScience ↗PubMed ↗

Abstract

In 12 glioblastoma patients treated with radio-chemotherapy, 2 cases (13%) were identified as pseudoprogression (PsPD).

Pseudoprogression is characterized by an apparent increase in tumor size and contrast enhancement shortly after radio-chemotherapy without worsening neurological symptoms.
In 21%-50% of malignant glioma patients, lesions that initially appear to progress may later disappear within a few months.
Two patients with PsPD experienced the longest progression and survival times among the group studied.
Both patients with PsPD had a methylated MGMT promoter, which may be associated with their outcomes.

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Pseudoprogression (PsPD) is a pathological feature recently reported by some authors in malignant glioma patients treated with radiotherapy in combination with temozolomide. In radiological imaging, it is shown as an increase in the size of the tumor lesion and contrast enhancement occurring within a few months from the completion of radio-chemotherapy without worsening of the neurological signs and symptoms. In 21%-50% of the patients, the same lesion disappears a few months after its appearance. In 12 glioblastoma patients treated with radio-chemotherapy, 4 cases of early radiological progression without discontinuation of temozolomide treatment are reported. At the sunsequent tumor assessment, 2 cases (13%) were revealed to be PsPD. The two patients who experienced PsPD had the longest progression and survival times of all patients. In both patients with PsPD, the O(6)-methylguanine-DNA methyltransferase (MGMT) promoter was found to be methylated. The PsPD phenomenon opens the prospect of a new era for the management of glioblastoma patients undergoing radio-chemotherapy.

Pseudoprogression and MGMT status in glioblastoma patients: implications in clinical practice.

Abstract

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