Improving Prognostic Prowess

New prognostic classification may help clinical decision-making in glioblastoma

Arnab Chakravarti 2New research shows that taking molecular variables into account will improve the prognostic classification of the lethal brain cancer called glioblastoma (GBM).

Led by researchers at the OSUCCC – James, the study found that adding significant molecular biomarkers to the existing GBM classification system improves the prognostic classification of GBM patients who have been treated with radiation and the drug temozolomide.

The current model, used internationally for nearly two decades, is based on clinical variables alone. It was created before the introduction of temozolomide, which along with radiation is the current standard of care for GBM.

The new, refined classification was derived using samples from 452 GBM patients treated with radiation and temozolomide. It includes such key molecular markers as MGMT-protein and c-MET-protein expression, along with such clinical variables as age, performance status, extent of resection and neurological function.

The researchers validated the model in an independent group of 176 patients.

“Our study has established and independently validated a novel molecular classification of glioblastoma, perhaps the most aggressive of all human malignancies,” says principal investigator Arnab Chakravarti, MD, professor and chair of the Department of Radiation Oncology at Ohio State and co-director of the Brain Tumor Program. “The revised model offers a more accurate assessment of prognostic groups in GBM patients who have been treated with radiation and temozolomide.

“We believe that incorporating c-MET- and MGMT-protein expression enhances the prognostic classification of glioblastoma patients over and above the traditional clinical variables, and that it will improve clinical decision-making,” says Chakravarti, who also holds the Max Morehouse Chair in Cancer Research at Ohio State. “Furthermore, inclusion of the MGMT protein provides insight into the potential for resistance to radiation and temozolomide.”

Published in the journal JAMA Oncology.

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