Revised Classification Should Improve Patient Care
Radiation oncology researchers have revised the system used by doctors since the 1990s to determine the prognosis of people with glioblastoma, the most devastating of malignant brain tumors.
The outdated system, which was devised for glioblastoma and related brain tumors that were treated by radiation therapy only, relied on clinical signs and symptoms, and it divided patients into six prognostic groups. The new system accommodates advances in treatment, particularly the use of radiation therapy plus the chemotherapy drug temozolomide, and incorporates molecular biomarkers as well as clinical variables.
“The new model is more relevant and contemporary, and it should do a better job of identifying patients who require the most aggressive therapy,” says Arnab Chakravarti, MD, the study’s chair for translational research.
Chakravarti, professor and chair of the Department of Radiation Oncology at Ohio State and co-director of the Brain Tumor Program at the OSUCCC – James, presented study findings at the 2012 annual meeting of Revised Classification Should Improve Patient Care the American Society of Clinical Oncology (ASCO) in Chicago.
To devise the new system, Chakravarti and colleagues compared tumor and healthy tissue from 162 glioblastoma patients who were treated under the Radiation Oncology Group clinical trial 0525 (RTOG 0525). The investigators profiled protein, messenger RNA and epigenetic changes in patients’ tumor cells while looking for alterations in key signaling molecules.
They showed that high expression of the proteins pAKT, c-met and MGMT was associated with poor prognosis, while methylation of the MGMT gene, which codes for a DNA repair protein, was associated with a better prognosis.
“We hope to begin further studies to validate our classification system soon,” Chakravarti says.
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