Inactivation of the DNA-Repair Gene MGMT and the Clinical Response of Gliomas to Alkylating Agents
Manel Esteller, M.D., Ph.D., Jesus Garcia-Foncillas, M.D., Ph.D., Esther Andion, B.Sc., Steven N. Goodman, M.D., Ph.D., Oscar F. Hidalgo, M.D., Vicente Vanaclocha, M.D., Stephen B. Baylin, M.D., and James G. Herman, M.D.
Background The DNA-repair enzyme O6-methylguanine-DNA methyltransferase(MGMT) inhibits the killing of tumor cells by alkylating agents.MGMT activity is controlled by a promoter; methylation of thepromoter silences the gene in cancer, and the cells no longerproduce MGMT. We examined gliomas to determine whether methylationof the MGMT promoter is related to the responsiveness of thetumor to alkylating agents.
Methods We analyzed the MGMT promoter in tumor DNA by a methylation-specificpolymerase-chain-reaction assay. The gliomas were obtained frompatients who had been treated with carmustine (1,3-bis(2-chloroethyl)-1-nitrosourea,or BCNU). The molecular data were correlated with the clinicaloutcome.
Results The MGMT promoter was methylated in gliomas from 19of 47 patients (40 percent). This finding was associated withregression of the tumor and prolonged overall and disease-freesurvival. It was an independent and stronger prognostic factorthan age, stage, tumor grade, or performance status.
Conclusions Methylation of the MGMT promoter in gliomas is auseful predictor of the responsiveness of the tumors to alkylatingagents.
Source Information
From the Divisions of Cancer Biology (M.E., S.B.B., J.G.H.) and Biostatistics (S.N.G.), Johns Hopkins Oncology Center, Baltimore; and the Biotechnology Laboratory, Cell Therapy Area, Department of Oncology, Clinica Universitaria, Pamplona, Spain (J.G.-F., E.A., O.F.H., V.V.).
Address reprint requests to Dr. Herman at the Johns Hopkins Oncology Center, 1650 Orleans, Baltimore, MD 21231, or at hermanji{at}jhmi.edu.
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