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publicado em 01/06/2011 às 21h20:00
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Test can distinguish patients with glioblastoma more or less aggressive

Change in a particular gene can identify which patients with brain cancer respond better to treatment

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Change in a particular gene can identify patients with a certain type of brain cancer will respond better to treatment. According to experts, the test for the gene can distinguish patients with a more or less aggressive glioblastoma, the most common and usually fatal brain cancer.

The prospective study found a gene called MGMT in tumors taken from 833 patients with glioblastoma. It was noted that when the promoter of the gene is altered by a chemical change called methylation, patients respond better to treatment.

"We have shown that MGMT methylation represents a new genetic test that can predict clinical outcomes in patients with glioblastoma who were treated with radiation combined with chemotherapy drug temozolomide. The glioblastomas are not equal, however, are a collection of different entities molecular and genetic behave in a unique and require personalized treatment, "Arnab Chakravarti expliaca.

"Our study confirms the prognostic significance of MGMT gene methylation and demonstrates the viability of the prospective collection of tumor tissue and molecular stratification of the meeting of patient results in a large intergroup trial," says Mark Gilbert.

The current study reinforces the conclusion of previous studies that methylation of MGMT has prognostic significance. Patients with tumors carrying the methylated gene had a survival of 21 months versus 14 months for those with an unmethylated gene. The difference in progression-free survival - the period after treatment when the cancer was not worse - was 8.7 months and 5.7 months for tumors methylated and unmethylated, respectively. The small difference, according to Chakravarti, indicates that patients with the gene methylated tumors had slower growth.

Predictions are that about 18,500 new cases of glioblastoma multiforme occur annually in the United States and that 12,760 Americans will die from the disease. Symptoms usually include headache, seizures and motor or sensory. A brain scan detected the tumor. Once a surgeon removes the tumor, it can be tested for methylation of MGMT.

"Patients with the methylated gene could receive standard treatment consisting of radiation therapy and temozolomide chemotherapy. Those who have an unmethylated gene may receive an experimental treatment through a clinical trial," says Chakravarti.

Research is needed now, he says, to know whether the MGMT directly contributes to tumor aggressiveness, or is just an indicator of other changes that cause tumor aggressiveness. "If the gene itself help cause the disease aggressively, MGMT or pathways of DNA repair may be important targets for new therapies," says Chakravarti.


   Palavras-chave:   Brain cancer    Glioblastoma    MGMT gene    Methylation    Genetic testing    Response to treatment   
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