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Case Report
 
Long-term survival with unmethylated MGMT glioblastoma multiforme
Joana Savva-Bordalo1, André Soares2, Patrícia Rocha3, Manuel Jácome4 Joaquina Maurício5 Rui Ferreira6
1Department of Medical Oncology & Cancer Epigenetics Group, Research Center; IPO-Porto, R, Dr. António Bernardino de Almeida, P 4200 072 Porto, Portugal.
2Department of Radiotherapy; IPO-Porto, R. Dr. António Bernardino de Almeida, P 4200 072 Porto, Portugal.
3Department of Genetics; IPO-Porto, R. Dr. António Bernardino de Almeida, P 4200 072 Porto, Portugal.
4Department of Pathology; IPO-Porto, R. Dr. António Bernardino de Almeida, P 4200 072 Porto, Portugal.
5Department of Medical Oncology & Cancer Epigenetics Group, Research Center; IPO-Porto, R, Dr. António Bernardino de Almeida, P 4200 072 Porto, Portugal.
6Department of Neurosurgery; IPO-Porto, R. Dr. António Bernardino de Almeida, P 4200 072 Porto, Portugal.

doi:10.5348/ijcri-2011-07-43-CR-3

Address correspondence to:
Joana Savva-Bordalo
IPO-Porto
Serviço de Oncologia Médica
R. Dr. António Bernardino de Almeida
P 4200 072 Porto
Portugal
Phone: +351 22 5084000
Fax: 351225084001
Email: joanasavva@gmail.com

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How to cite this article:
Savva-Bordalo J, Soares A, Rocha P, Jácome M, Maurício J, Ferreira R. Long-term survival with unmethylated MGMT glioblastoma multiforme. International Journal of Case Reports and Images 2011;2(7):8-12.


Abstract
Introduction: Glioblastoma multiforme is the most aggressive tumor of the central nervous system. Despite advances in its management, overall prognosis remains poor, with a median survival time of less than one year. Good response to chemotherapy with temozolomide (TMZ) is usually associated with methylation of the promoter of the O(6)-methylguanine-DNA methyltransferase (MGMT) gene.
Case Report: We describe here a patient with glioblastoma multiforme, who had good prognostic clinical features, age and performance status, but unmethylated MGMT promoter and who survived for eight years while treated with a multi-modal approach.
Conclusion: Good response to treatment, despite the absence of MGMT hypermethylation, suggests that other genetic or molecular factors may predict prognosis and therapeutic response in patients with glioblastoma multiforme.

Key Words: Glioblastoma, O(6)-Methylguanine-DNA Methyltransferase, Methylation, Temozolomide

Acknowledgements

We thank Ana Isabel Salgado for reviewing brain imaging, Joana Vieira for the collaboration in the genetic analysis, António Verdelho and Machado Carvalho for their suggestions and support.


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Author Contributions:
Joana Savva-Bordalo - Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
André Soares - Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published
Patrícia Rocha, Manuel Jácome - Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published
Joaquina Maurício - Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published
Rui Ferreira - Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission:
The corresponding author is the guarantor of submission.
Source of support:
None
Conflict of interest:
Authors declare no conflict of interest.
Copyright:
© Joana Savva-Bordalo et. al. 2011; This article is distributed the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any means provided the original authors and original publisher are properly credited. (Please see Copyright Policy for more information.)