Al's Comment:

This can be practice changing.  We previously reported that Temozolomide did not help patients with Glioblastoma that have unmethylated MGMT and the Wild Type IDK. This confirms it, and in the opinion of the authors, makes it Ok to not use Temozolomide on patients in this group, and try something else.  We have always been afraid of trying this because there was a small "tail" of survivors in the trials of patients with unmethylated MGMT who did do well with Temozolomide.  This article explains that the old test was not specific enough, and says they now break down the MGMT result into 3 groups, highly methylated, where Temozolomide has a good chance of helping, low (truly) unmethylated which has no chance of Temozolomide helping, and the intermediate range where there may be a small benefit. They say that those in the intermediate group were labelled as unmethylated and they account for those responders in the old trials.

Posted on: 01/22/2021

The Role of Temozolomide in Patients With Newly Diagnosed Wild-Type IDH, Unmethylated MGMTp Glioblastoma During the COVID-19 Pandemic


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