Department of Radiation Oncology, Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, South Korea.
Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, South Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea.
Radiother Oncol. 2018 Nov;129(2):347-351. doi: 10.1016/j.radonc.2018.09.001. Epub 2018 Sep 17.
A novel molecular recursive partitioning analysis classification has recently been reported integrating the MGMT promoter methylation (MGMTmeth) and IDH1 mutation (IDH1mut) status for glioblastoma (GBM-molRPA) patients treated with temozolomide-based chemoradiation. The current study was initiated to validate the model in a multi-institutional study.
Four-hundred seventy-one newly diagnosed GBM patients (validation cohort) were allocated to classes I-III of the previously reported GBM-molRPA model. Of the patients, 15.7%, 56.1%, and 28.2% patients were GBM-molRPA class I, II, and III, respectively. MGMTmeth and IDH1mut were observed in 32.3 and 8.8% of patients, respectively. In the training plus validation cohort of 692 patients, 16.2%, 60.8%, and 23.0% patients were class I, II, and III, respectively.
The median follow-up for survivors and the median survival (MS) of patients was 23.3 and 18.4 months, respectively. The MS for GBM-molRPA class I, II, and III was 49.7 (95% CI, 22.8-76.6), 19.2 (95% CI, 16.2-22.1), and 13.8 months (95% CI, 11.8-15.4) (P < .001 for all comparisons) in the validation cohort. In the training plus validation cohort, the MS was 58.5 (95% CI, 40.7-76.3), 21. (95% CI, 18.6-23.3), and 14.3 months (95% CI, 12.5-16.1) (P < .001 for all comparisons) for class I, II, and III, respectively.
The GBM-molRPA is a valid model. This GBM-molRPA classification can be useful in clinics and guiding patient stratification in future clinical trials.
最近报道了一种新的分子递归分区分析分类，该分类将替莫唑胺为基础的放化疗治疗的胶质母细胞瘤（GBM-molRPA）患者的 MGMT 启动子甲基化（MGMTmeth）和 IDH1 突变（IDH1mut）状态整合在一起。本研究旨在通过多机构研究验证该模型。
471 例新诊断的胶质母细胞瘤患者（验证队列）被分配到之前报道的 GBM-molRPA 模型的 I-III 类。在患者中，分别有 15.7%、56.1%和 28.2%的患者为 GBM-molRPA 类 I、II 和 III。MGMTmeth 和 IDH1mut 的发生率分别为 32.3%和 8.8%。在 692 例培训加验证队列的患者中，分别有 16.2%、60.8%和 23.0%的患者为 I、II 和 III 类。
幸存者的中位随访时间和患者的中位生存时间（MS）分别为 23.3 个月和 18.4 个月。GBM-molRPA 类 I、II 和 III 的 MS 分别为 49.7（95%CI，22.8-76.6）、19.2（95%CI，16.2-22.1）和 13.8 个月（95%CI，11.8-15.4）（所有比较 P<.001）在验证队列中。在培训加验证队列中，MS 分别为 58.5（95%CI，40.7-76.3）、21.（95%CI，18.6-23.3）和 14.3 个月（95%CI，12.5-16.1）（所有比较 P<.001）为 I、II 和 III 类。
GBM-molRPA 是一种有效的模型。该 GBM-molRPA 分类可用于临床，并在未来的临床试验中指导患者分层。
