A systematic review of high impact CpG sites and regions for MGMT methylation in glioblastoma [A systematic review of MGMT methylation in GBM].

CpG Epigenetics Glioblastoma MGMT Methylation

Journal

BMC neurology
ISSN: 1471-2377
Titre abrégé: BMC Neurol
Pays: England
ID NLM: 100968555

Informations de publication

Date de publication:
23 Mar 2024
Historique:
received: 06 10 2023
accepted: 17 03 2024
medline: 24 3 2024
pubmed: 24 3 2024
entrez: 24 3 2024
Statut: epublish

Résumé

MGMT (O 6 -methylguanine-DNA methyltransferase) promoter methylation is a commonly assessed prognostic marker in glioblastoma (GBM). Epigenetic silencing of the MGMT gene by promoter methylation is associated with greater overall and progression free survival with alkylating agent regimens. To date, there is marked heterogeneity in how MGMT promoter methylation is tested and which CpG sites are interrogated. To further elucidate which MGMT promoter CpG sites are of greatest interest, we performed comprehensive searches in PubMed, Web of Science, and Embase and reviewed 2,925 article abstracts. We followed the GRADE scoring system to assess risk of bias and the quality of the studies we included. We included articles on adult glioblastoma that examined significant sites or regions within MGMT promoter for the outcomes: overall survival, progression free survival, and/or MGMT expression. We excluded systemic reviews and articles on lower grade glioma. fifteen articles met inclusion criteria with variable overlap in laboratory and statistical methods employed, as well as CpG sites interrogated. Pyrosequencing or BeadChip arrays were the most popular methods utilized, and CpG sites between CpG's 70-90 were most frequently investigated. Overall, there was moderate concordance between the CpG sites that the studies reported to be highly predictive of prognosis. Combinations or means of sites between CpG's 73-89 were associated with improved OS and PFS. Six studies identified CpG sites associated with prognosis that were closer to the transcription start site: CpG's 8, 19, 22, 25, 27, 32,38, and CpG sites 21-37, as well as low methylation level of the enhancer regions. The following systematic review details a comprehensive investigation of the current literature and highlights several potential key CpG sites that demonstrate significant association with OS, PFS, and MGMT expression. However, the relationship between extent of MGMT promoter methylation and survival may be non-linear and could be influenced by potential CpG hotspots, the extent of methylation at each CpG site, and MGMT enhancer methylation status. There were several limitations within the studies such as smaller sample sizes, variance between methylation testing methods, and differences in the various statistical methods to test for association to outcome. Further studies of high impact CpG sites in MGMT methylation is warranted.

Sections du résumé

BACKGROUND BACKGROUND
MGMT (O 6 -methylguanine-DNA methyltransferase) promoter methylation is a commonly assessed prognostic marker in glioblastoma (GBM). Epigenetic silencing of the MGMT gene by promoter methylation is associated with greater overall and progression free survival with alkylating agent regimens. To date, there is marked heterogeneity in how MGMT promoter methylation is tested and which CpG sites are interrogated.
METHODS METHODS
To further elucidate which MGMT promoter CpG sites are of greatest interest, we performed comprehensive searches in PubMed, Web of Science, and Embase and reviewed 2,925 article abstracts. We followed the GRADE scoring system to assess risk of bias and the quality of the studies we included.
RESULTS RESULTS
We included articles on adult glioblastoma that examined significant sites or regions within MGMT promoter for the outcomes: overall survival, progression free survival, and/or MGMT expression. We excluded systemic reviews and articles on lower grade glioma. fifteen articles met inclusion criteria with variable overlap in laboratory and statistical methods employed, as well as CpG sites interrogated. Pyrosequencing or BeadChip arrays were the most popular methods utilized, and CpG sites between CpG's 70-90 were most frequently investigated. Overall, there was moderate concordance between the CpG sites that the studies reported to be highly predictive of prognosis. Combinations or means of sites between CpG's 73-89 were associated with improved OS and PFS. Six studies identified CpG sites associated with prognosis that were closer to the transcription start site: CpG's 8, 19, 22, 25, 27, 32,38, and CpG sites 21-37, as well as low methylation level of the enhancer regions.
CONCLUSION CONCLUSIONS
The following systematic review details a comprehensive investigation of the current literature and highlights several potential key CpG sites that demonstrate significant association with OS, PFS, and MGMT expression. However, the relationship between extent of MGMT promoter methylation and survival may be non-linear and could be influenced by potential CpG hotspots, the extent of methylation at each CpG site, and MGMT enhancer methylation status. There were several limitations within the studies such as smaller sample sizes, variance between methylation testing methods, and differences in the various statistical methods to test for association to outcome. Further studies of high impact CpG sites in MGMT methylation is warranted.

Identifiants

pubmed: 38521933
doi: 10.1186/s12883-024-03605-3
pii: 10.1186/s12883-024-03605-3
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

103

Informations de copyright

© 2024. The Author(s).

Références

Chai R, Zhang K, Liu Y, et al. Combinations of four or more CpGs methylation present equivalent predictive value for MGMT expression and temozolomide therapeutic prognosis in gliomas. CNS Neurosci Ther. 2019;25(3):314–22. https://doi.org/10.1111/cns.13040 .
doi: 10.1111/cns.13040 pubmed: 30117294
Louis DN, Perry A, Wesseling P, et al. The 2021 WHO classification of tumors of the central nervous system: a summary. Neuro Oncol. 2021;23(8):1231–51. https://doi.org/10.1093/neuonc/noab106 .
doi: 10.1093/neuonc/noab106 pubmed: 34185076 pmcid: 8328013
Yuan G, Niu L, Zhang Y, et al. Defining optimal cutoff value of MGMT promoter methylation by ROC analysis for clinical setting in glioblastoma patients. J Neurooncol. 2017;133(1):193–201. https://doi.org/10.1007/s11060-017-2433-9 .
doi: 10.1007/s11060-017-2433-9 pubmed: 28516344
Gerson SL. MGMT: its role in cancer aetiology and cancer therapeutics. Nat Rev Cancer. 2004;4(4):296–307. https://doi.org/10.1038/nrc1319 .
doi: 10.1038/nrc1319 pubmed: 15057289
Silber JR, Bobola MS, Blank A, Chamberlain MC. O(6)-methylguanine-DNA methyltransferase in glioma therapy: promise and problems. Biochim Biophys Acta. 2012;1826(1):71–82. https://doi.org/10.1016/j.bbcan.2011.12.004 .
doi: 10.1016/j.bbcan.2011.12.004 pubmed: 22244911 pmcid: 3340514
Esteller M, Garcia-Foncillas J, Andion E, et al. Inactivation of the DNA-repair gene MGMT and the clinical response of gliomas to Alkylating agents. N Engl J Med. 2000;343(19):1350–4. https://doi.org/10.1056/NEJM200011093431901 .
doi: 10.1056/NEJM200011093431901 pubmed: 11070098
Rivera AL, Pelloski CE, Gilbert MR, et al. MGMT promoter methylation is predictive of response to radiotherapy and prognostic in the absence of adjuvant alkylating chemotherapy for glioblastoma. Neuro Oncol. 2010;12(2):116–21. https://doi.org/10.1093/neuonc/nop020 .
doi: 10.1093/neuonc/nop020 pubmed: 20150378
Bhakat KK, Mitra S. Regulation of the human O(6)-methylguanine-DNA methyltransferase gene by transcriptional coactivators cAMP response element-binding protein-binding protein and p300. J Biol Chem. 2000;275(44):34197–204. https://doi.org/10.1074/jbc.M005447200 .
doi: 10.1074/jbc.M005447200 pubmed: 10942771
Pegg AE. Repair of O(6)-alkylguanine by alkyltransferases. Mutat Res. 2000;462(2–3):83–100. https://doi.org/10.1016/s1383-5742(00)00017-x .
doi: 10.1016/s1383-5742(00)00017-x pubmed: 10767620
Szopa W, Burley TA, Kramer-Marek G, Kaspera W. Diagnostic and therapeutic biomarkers in glioblastoma: current status and future perspectives. Biomed Res Int. 2017;2017:8013575. https://doi.org/10.1155/2017/8013575 .
doi: 10.1155/2017/8013575 pubmed: 28316990 pmcid: 5337853
Wick W, Weller M. Anaplastic glioma. Nervenarzt. 2010;81(8):928. https://doi.org/10.1007/s00115-010-2956-1 .
doi: 10.1007/s00115-010-2956-1 pubmed: 20635074
Watts GS, Pieper RO, Costello JF, Peng YM, Dalton WS, Futscher BW. Methylation of discrete regions of the O6-methylguanine DNA methyltransferase (MGMT) CpG island is associated with heterochromatinization of the MGMT transcription start site and silencing of the gene. Mol Cell Biol. 1997;17(9):5612–9. https://doi.org/10.1128/MCB.17.9.5612 .
doi: 10.1128/MCB.17.9.5612 pubmed: 9271436 pmcid: 232409
Pieper RO, Patel S, Ting SA, Futscher BW, Costello JF. Methylation of CpG island transcription factor binding sites is unnecessary for aberrant silencing of the human MGMT gene. J Biol Chem. 1996;271(23):13916–24. https://doi.org/10.1074/jbc.271.23.13916 .
doi: 10.1074/jbc.271.23.13916 pubmed: 8662860
Everhard S, Tost J, El Abdalaoui H, et al. Identification of regions correlating MGMT promoter methylation and gene expression in glioblastomas. Neuro Oncol. 2009;11(4):348–56. https://doi.org/10.1215/15228517-2009-001 .
doi: 10.1215/15228517-2009-001 pubmed: 19224763 pmcid: 2743215
Quillien V, Lavenu A, Sanson M, et al. Outcome-based determination of optimal pyrosequencing assay for MGMT methylation detection in glioblastoma patients. J Neurooncol. 2014;116(3):487–96. https://doi.org/10.1007/s11060-013-1332-y .
doi: 10.1007/s11060-013-1332-y pubmed: 24420923 pmcid: 3905192
De Carlo E, Gerratana L, Gurrieri L, et al. Prognostic value of MGMT gene promoter methylation evaluated on ten CpG sites in patients with glioblastoma multiforme: a single-institution experience. Ann Oncol. 2015;26:vi136. https://doi.org/10.1093/annonc/mdv348.14 .
doi: 10.1093/annonc/mdv348.14
Malley DS, Hamoudi RA, Kocialkowski S, Pearson DM, Collins VP, Ichimura K. A distinct region of the MGMT CpG island critical for transcriptional regulation is preferentially methylated in glioblastoma cells and xenografts. Acta Neuropathol. 2011;121(5):651–61. https://doi.org/10.1007/s00401-011-0803-5 .
doi: 10.1007/s00401-011-0803-5 pubmed: 21287394
Yildiz O, Aslan D, Akalin H, et al. The effects of O
doi: 10.2478/bjmg-2020-0015 pubmed: 32953407 pmcid: 7474218
Mur P, Rodríguez de Lope Á, Díaz-Crespo FJ, et al. Impact on prognosis of the regional distribution of MGMT methylation with respect to the CpG island methylator phenotype and age in glioma patients. J Neurooncol. 2015;122(3):441–50. https://doi.org/10.1007/s11060-015-1738-9 .
doi: 10.1007/s11060-015-1738-9 pubmed: 25682093
Bady P, Sciuscio D, Diserens AC, et al. MGMT methylation analysis of glioblastoma on the infinium methylation BeadChip identifies two distinct CpG regions associated with gene silencing and outcome, yielding a prediction model for comparisons across datasets, tumor grades, and CIMP-status. Acta Neuropathol. 2012;124(4):547–60. https://doi.org/10.1007/s00401-012-1016-2 .
doi: 10.1007/s00401-012-1016-2 pubmed: 22810491 pmcid: 3444709
Shah N, Lin B, Sibenaller Z, et al. Comprehensive analysis of MGMT promoter methylation: correlation with MGMT expression and clinical response in GBM. Jones C, ed. PLoS One. 2011;6(1):e16146. https://doi.org/10.1371/journal.pone.0016146 .
doi: 10.1371/journal.pone.0016146 pubmed: 21249131 pmcid: 3017549
Siller S, Lauseker M, Karschnia P, et al. The number of methylated CpG sites within the MGMT promoter region linearly correlates with outcome in glioblastoma receiving alkylating agents. Acta Neuropathol Commun. 2021;9(1):35. https://doi.org/10.1186/s40478-021-01134-5 .
doi: 10.1186/s40478-021-01134-5 pubmed: 33663593 pmcid: 7934240
Caccese M, Simonelli M, Villani V, et al. Definition of the prognostic role of MGMT promoter methylation value by pyrosequencing in newly diagnosed IDH wild-type glioblastoma patients treated with radiochemotherapy: a large multicenter study. Cancers (Basel). 2022;14(10). https://doi.org/10.3390/cancers14102425 .
Leske H, Camenisch Gross U, Hofer S, et al. MGMT methylation pattern of long-term and short-term survivors of glioblastoma reveals CpGs of the enhancer region to be of high prognostic value. Acta Neuropathol Commun. 2023;11(1):139. https://doi.org/10.1186/s40478-023-01622-w .
doi: 10.1186/s40478-023-01622-w pubmed: 37641156 pmcid: 10463744
Buyuktepe M, Kaplan I, Bayatli E, Dogan H, Ugur HC. Significance of O6-methyl guanine methyltransferase promoter methylation in high grade glioma patients: optimal cutoff point, CpG locus, and genetic assay. J Neurooncol. 2023;164(1):171–7. https://doi.org/10.1007/s11060-023-04397-1 .
doi: 10.1007/s11060-023-04397-1 pubmed: 37474746
Gibson D, Ravi A, Rodriguez E, et al. Quantitative analysis of MGMT promoter methylation in glioblastoma suggests nonlinear prognostic effect. Neurooncol Adv. 2023;5(1):vdad115. https://doi.org/10.1093/noajnl/vdad115 .
doi: 10.1093/noajnl/vdad115 pubmed: 37899778 pmcid: 10611422
Zappe K, Pühringer K, Pflug S, et al. Association between MGMT enhancer methylation and MGMT promoter methylation, MGMT protein expression, and overall survival in glioblastoma. Cells. 2023;12(12). https://doi.org/10.3390/cells12121639 .
doi: 10.3390/cells12121639 pubmed: 37371109 pmcid: 10297309
Hackenberg M, Barturen G, Carpena P, Luque-Escamilla PL, Previti C, Oliver JL. Prediction of CpG-island function: CpG clustering vs. sliding-window methods. BMC Genomics. 2010;11. https://doi.org/10.1186/1471-2164-11-327 .
doi: 10.1186/1471-2164-11-327 pubmed: 20500903 pmcid: 2887419
Wenger A, Ferreyra Vega S, Kling T, Bontell TO, Jakola AS, Carén H. Intratumor DNA methylation heterogeneity in glioblastoma: implications for DNA methylation-based classification. Neuro Oncol. 2019;21(5):616–27. https://doi.org/10.1093/neuonc/noz011 .
doi: 10.1093/neuonc/noz011 pubmed: 30668814 pmcid: 6502500
Aasland D, Reich TR, Tomicic MT, Switzeny OJ, Kaina B, Christmann M. Repair gene O
doi: 10.1111/jnc.14262 pubmed: 29164620
Molenaar RJ, Verbaan D, Lamba S, et al. The combination of IDH1 mutations and MGMT methylation status predicts survival in glioblastoma better than either IDH1 or MGMT alone. Neuro Oncol. 2014;16(9):1263–73. https://doi.org/10.1093/neuonc/nou005 .
doi: 10.1093/neuonc/nou005 pubmed: 24510240 pmcid: 4136888

Auteurs

David Gibson (D)

Department of Neuro-Oncology, University of California, San Francisco, 400 Parnassus Ave, San Francisco, CA, USA.
Department of Bioinformatics, University of California, Los Angeles, Los Angeles, CA, USA.

Anh Huan Vo (AH)

Department of Neuro-Oncology, University of California, San Francisco, 400 Parnassus Ave, San Francisco, CA, USA. ahv2019@outlook.com.

Hannah Lambing (H)

Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA.
Department of Human Genetics, University of California, Los Angeles, Los Angeles, CA, USA.

Prithanjan Bhattacharya (P)

Department of Neuro-Oncology, University of California, San Francisco, 400 Parnassus Ave, San Francisco, CA, USA.

Peggy Tahir (P)

University of California, San Francisco Library, San Francisco, CA, USA.

Farid F Chehab (FF)

Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA.

Nicholas Butowski (N)

Department of Neuro-Oncology, University of California, San Francisco, 400 Parnassus Ave, San Francisco, CA, USA.

Classifications MeSH