Yan Chengrui, Bai Xuexue, Wu Chao, Ma Wenbin, Feng Ming
Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.
Department of Neurosurgery, Tengzhou Central People's Hospital, Tengzhou, Shandong, China.
Front Oncol. 2025 Sep 2;15:1644934. doi: 10.3389/fonc.2025.1644934. eCollection 2025.
The aim of this study is to investigate whether the therapeutic efficacy of bevacizumab (BEV) in the treatment of high-grade glioma (HGG) is associated with the methylation status of O6-methylguanine-DNA methyltransferase (MGMT) on the basis of excluding the interference from chemotherapy drugs.
This study included 57 patients with histologically confirmed HGG who, due to various reasons, were unable to complete the standard chemotherapy protocol and thus received BEV treatment. Patients enrolled in the study were divided into two groups based on their MGMT status: the unmethylated MGMT group and the methylated MGMT group. Depending on whether the numerical variables of the patients satisfied a normal distribution, either the T-test or the rank-sum test was employed. For the comparison of categorical variables, the chi-square test was used.
After BEV treatment, both PFS and OS were higher in the methylated MGMT group compared to the unmethylated group. Additionally, the tumor control rate was also higher in the methylated group. Furthermore, in both patient groups, a decrease in steroid dosage was observed following BEV treatment, accompanied by an increase in KPS. Multivariate COX regression analysis revealed that radiotherapy and complete tumor resection were significant factors influencing PFS and OS in HGG patients. Additionally, pathological grade was found to influence PFS in HGG patients.
Based on the exclusion of the interference from chemotherapy drugs, our study is the first to confirm the correlation between the methylation status of MGMT and the therapeutic effect of BEV on HGG.
本研究旨在排除化疗药物干扰的基础上，探讨贝伐单抗（BEV）治疗高级别胶质瘤（HGG）的疗效是否与O6-甲基鸟嘌呤-DNA甲基转移酶（MGMT）的甲基化状态相关。
本研究纳入57例经组织学确诊的HGG患者，这些患者因各种原因无法完成标准化疗方案，因此接受了BEV治疗。根据MGMT状态将纳入研究的患者分为两组：MGMT未甲基化组和MGMT甲基化组。根据患者的数值变量是否满足正态分布，采用t检验或秩和检验。对于分类变量的比较，采用卡方检验。
BEV治疗后，MGMT甲基化组的无进展生存期（PFS）和总生存期（OS）均高于未甲基化组。此外，甲基化组的肿瘤控制率也更高。此外，在两组患者中，BEV治疗后均观察到类固醇剂量减少，同时KPS增加。多因素COX回归分析显示，放疗和肿瘤完全切除是影响HGG患者PFS和OS的重要因素。此外，病理分级被发现影响HGG患者的PFS。
在排除化疗药物干扰的基础上，本研究首次证实MGMT甲基化状态与BEV对HGG的治疗效果之间存在相关性。
