MGMT promoter gene methylation and Neurological Scale Improvement in Glioma: a cohort study

Abstract

Background: Glioma as one of the most common primary brain tumors remains to convey a dismal prognosis despite of aggressive treatment. Several biomarkers have been studied in hope to yield diagnostic accuracy and improve patient management.  Besides of survival, functional and neurological disability is one of the concerns that have no lesser importance. In 2017, a disease-specific assessment tool – the NANO scale – was developed to measure neurologic function in neuro-oncology cases. We sought to determine biomarkers that might be associated with neurological scale improvement in glioma patients.

Methods: Glioma grade II-IV were recruited from 3 major hospitals in Jakarta-Tangerang. IDH mutation and MGMT promoter gene methylation were tested, as well as patients’ neurological scale before surgery and 3 months after. Improvement in neurological scale (NANO scale) is considered positive if there was a decrement of ≥1 of the scale.

Results: There were 54 patients included in the study. Mean age was 43.63 (14.723) years old, and 61.1% were male. As much as 16 (29.6%) carried a mutation in codon 132 of the IDH1 gene, and 33 (61.1%) were MGMT methylated. Median NANO Scale before and 3 months after surgery was 4 (0-12) and 3(0-12). Improvement in neurological scale was found in 44 (81.5%) of the patients. Among patients with MGMT promoter gene methylation, 90.9% shows improvement in neurological scale (p=0.035; OR=5; 95%CI 1.122-22.272).

Conclusions: Glioma with MGMT promoter gene methylation are more likely to show neurological scale improvement 3 months after surgery.