MGMT promoter gene methylation and Neurological Scale Improvement in Glioma: a cohort study

<p><strong>Abstract</strong></p> <p><strong>Background:</strong> Glioma as one of the most common primary brain tumors remains to convey a dismal prognosis despite of aggressive treatment. Several biomarkers have been studied in hope to yield diagnostic accuracy and improve patient management.&nbsp; Besides of survival, functional and neurological disability is one of the concerns that have no lesser importance. In 2017, a disease-specific assessment tool &ndash; the NANO scale &ndash; was developed to measure neurologic function in neuro-oncology cases. We sought to determine biomarkers that might be associated with neurological scale improvement in glioma patients.</p> <p>&nbsp;</p> <p>&nbsp;</p> <p><strong>Methods:</strong> Glioma grade II-IV were recruited from 3 major hospitals in Jakarta-Tangerang. IDH mutation and MGMT promoter gene methylation were tested, as well as patients&rsquo; neurological scale before surgery and 3 months after. Improvement in neurological scale (NANO scale) is considered positive if there was a decrement of &ge;1 of the scale.</p> <p>&nbsp;</p> <p><strong>Results:</strong> There were 54 patients included in the study. Mean age was 43.63 (14.723) years old, and 61.1% were male. As much as 16 (29.6%) carried a mutation in codon 132 of the IDH1 gene, and 33 (61.1%) were MGMT methylated. Median NANO Scale before and 3 months after surgery was 4 (0-12) and 3(0-12). Improvement in neurological scale was found in 44 (81.5%) of the patients. Among patients with MGMT promoter gene methylation, 90.9% shows improvement in neurological scale (p=0.035; OR=5; 95%CI 1.122-22.272).</p> <p>&nbsp;</p> <p><strong>Conclusions:</strong> Glioma with MGMT promoter gene methylation are more likely to show neurological scale improvement 3 months after surgery.</p>