Prognostic and predictive value of p53 in low MGMT expressing glioblastoma treated with surgery, radiation and adjuvant temozolomide chemotherapy
- 1 September 2010
- journal article
- Published by Taylor & Francis Ltd in Neurological Research
- Vol. 32 (7), 690-694
- https://doi.org/10.1179/016164109x12478302362536
Abstract
To assess the prognostic and predictive significance of p53 protein expression in low O6-methylguanine-DNA methyltransferase (MGMT) expressing glioblastoma multiform (GBM) treated with combined therapy. The authors reviewed the clinical outcomes of 46 low MGMT expressing GBM patients who had undergone surgery, conventional local radiotherapy and temozolomide chemotherapy. Correlation between p53 expression level and clinical outcomes were analysed with univariate and multivariate Cox model. Patients with low p53 expression had a significantly improved progression free survival (PFS) (p=0.015) and overall survival (OS) (p=0.047) compared to those with high expression. On both univariate and multivariate analyses, low p53 expression persisted as a significant independent favorable prognostic factor for PFS (p=0.017). Pre-operative Karnofsky performance status score (p=0.029), tumor resection extent (p=0.045) and p53 expression level (p=0.038) were significant independent prognostic factors for OS. In these low MGMT expressing GBM patients with combined treatment, low p53 expression was a significant independent favorable prognostic factor for both PFS and OS. In addition to MGMT, p53 may be another stratification variable in the future therapeutic trials.Keywords
This publication has 39 references indexed in Scilit:
- Nitrosourea efficacy in high-grade glioma: a survival gain analysis summarizing 504 cohorts with 24193 patientsJournal of Neuro-Oncology, 2008
- Radiotherapy and Temozolomide for Newly Diagnosed Glioblastoma: Recursive Partitioning Analysis of the EORTC 26981/22981-NCIC CE3 Phase III Randomized TrialJournal of Clinical Oncology, 2006
- Treatment of Glioblastoma MultiformeArchives of Neurology, 2006
- Changing Paradigms—An Update on the Multidisciplinary Management of Malignant GliomaThe Oncologist, 2006
- Food and Drug Administration Drug Approval Summary: Temozolomide Plus Radiation Therapy for the Treatment of Newly Diagnosed Glioblastoma MultiformeClinical Cancer Research, 2005
- Radiotherapy plus Concomitant and Adjuvant Temozolomide for GlioblastomaThe New England Journal of Medicine, 2005
- Phase III Study Comparing Three Cycles of Infusional Carmustine and Cisplatin Followed by Radiation Therapy With Radiation Therapy and Concurrent Carmustine in Patients With Newly Diagnosed Supratentorial Glioblastoma Multiforme: Eastern Cooperative Oncology Group Trial 2394Journal of Clinical Oncology, 2003
- Chemotherapy in adult high-grade glioma: a systematic review and meta-analysis of individual patient data from 12 randomised trialsThe Lancet, 2002
- Meta-analysis of radiation therapy with and without adjuvant chemotherapy for malignant gliomas in adultsCancer, 1993
- Randomized Comparisons of Radiotherapy and Nitrosoureas for the Treatment of Malignant Glioma after SurgeryThe New England Journal of Medicine, 1980