Telomerase reverse transcriptase promoter mutation– and O6-methylguanine DNA methyltransferase promoter methylation–mediated sensitivity to temozolomide in isocitrate dehydrogenase–wild-type glioblastoma: is there a link?

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Dorothee Gramatzki - , University of Zurich (Author)
  • Jörg Felsberg - , Heinrich Heine University Düsseldorf (Author)
  • Bettina Hentschel - , Leipzig University (Author)
  • Marietta Wolter - , Heinrich Heine University Düsseldorf (Author)
  • Gabriele Schackert - , TUD Dresden University of Technology (Author)
  • Manfred Westphal - , University of Hamburg (Author)
  • Luca Regli - , University of Zurich (Author)
  • Niklas Thon - , Ludwig Maximilian University of Munich (Author)
  • Marcos Tatagiba - , University of Tübingen (Author)
  • Wolfgang Wick - , Heidelberg University , German Cancer Research Center (DKFZ) (Author)
  • Uwe Schlegel - , Ruhr University Bochum (Author)
  • Dietmar Krex - , Department of Neurosurgery, TUD Dresden University of Technology (Author)
  • Jakob Matschke - , University of Hamburg (Author)
  • Patrick Roth - , University of Zurich (Author)
  • Marian P. Suresh - , Heinrich Heine University Düsseldorf (Author)
  • Marcel A. Kamp - , Heinrich Heine University Düsseldorf (Author)
  • Elisabeth J. Rushing - , University of Zurich (Author)
  • Torsten Pietsch - , University of Bonn (Author)
  • Andreas von Deimling - , Heidelberg University  (Author)
  • Michael Sabel - , Heinrich Heine University Düsseldorf (Author)
  • Markus Loeffler - , Leipzig University (Author)
  • Michael Weller - , University of Zurich (Author)
  • Guido Reifenberger - , Heinrich Heine University Düsseldorf, German Cancer Research Center (DKFZ) (Author)

Abstract

Aim of the study: Benefit from temozolomide (TMZ) chemotherapy in the treatment of isocitrate dehydrogenase (IDH)–wild-type glioblastoma is essentially limited to patients with O6-methylguanine DNA methyltransferase (MGMT) promoter–methylated tumours. Recent studies suggested that telomerase reverse transcriptase (TERT) promoter hotspot mutations may have an impact on the prognostic role of the MGMT status in patients with glioblastoma. Methods: MGMT promoter methylation and TERT promoter mutation status were retrospectively assessed in a prospective cohort of patients with IDH–wild-type glioblastoma of the German Glioma Network (GGN) (n = 298) and an independent retrospective cohort from Düsseldorf, Germany, and Zurich, Switzerland (n = 302). Results: In the GGN cohort, but not in the Düsseldorf/Zurich cohort, TERT promoter mutation was moderately associated with inferior outcomes in patients with MGMT promoter–unmethylated tumours (hazard ratio 1.74; 95% confidence interval: 1.07–2.82; p = 0.026). TERT promoter mutations were not associated with better outcomes in patients with MGMT promoter–methylated tumours in either cohort. The two different TERT promoter hotspot mutations (C228T and C250T) were not linked to distinct outcomes. Conclusions: Analysis of two independent cohorts of patients with glioblastoma did not confirm previous data, suggesting that TERT promoter mutations confer an enhanced benefit from TMZ in patients with MGMT promoter–methylated glioblastoma. Thus, diagnostic testing for TERT promoter mutations may not be required for prediction of TMZ sensitivity in patients with IDH–wild-type glioblastoma.

Details

Original languageEnglish
Pages (from-to)84-94
Number of pages11
JournalEuropean journal of cancer
Volume147
Publication statusPublished - Apr 2021
Peer-reviewedYes

External IDs

PubMed 33631540

Keywords

Sustainable Development Goals

ASJC Scopus subject areas

Keywords

  • Glioblastoma, IDH–, MGMT, Survival, Temozolomide, TERT, wild-type