Evidence map›Paper›PMID 39907975›Full record

ArticleJournal of neuro-oncology2025

Treatment practices and survival outcomes for IDH-wildtype glioblastoma patients according to MGMT promoter methylation status: insights from the U.S. National Cancer Database.

John Pham, David J Cote, Keiko Kang, Robert G Briggs, David Gomez, Apurva Prasad, Sindhu Daggupati, Jonathan Sisti, Frances Chow, Frank Attenello and 2 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of neuro-oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

19 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

John PhamDepartment of Neurosurgery, The Warren Alpert Medical School of Brown University, Providence, RI, 02903, USA. john_pham1@brown.edu.
David J CoteDepartment of Neurosurgery, University of Southern California Keck School of Medicine, Los Angeles, CA, 90033, USA.
Keiko KangDepartment of Neurosurgery, University of Southern California Keck School of Medicine, Los Angeles, CA, 90033, USA.
Robert G BriggsDepartment of Neurosurgery, University of Southern California Keck School of Medicine, Los Angeles, CA, 90033, USA.
David GomezDepartment of Neurosurgery, University of Southern California Keck School of Medicine, Los Angeles, CA, 90033, USA.
Apurva PrasadDepartment of Neurosurgery, University of Southern California Keck School of Medicine, Los Angeles, CA, 90033, USA.
Sindhu DaggupatiDepartment of Neurosurgery, University of Southern California Keck School of Medicine, Los Angeles, CA, 90033, USA.
Jonathan SistiDepartment of Neurosurgery, University of Southern California Keck School of Medicine, Los Angeles, CA, 90033, USA.
Frances ChowDepartment of Neurosurgery, University of Southern California Keck School of Medicine, Los Angeles, CA, 90033, USA.
Frank AttenelloDepartment of Neurosurgery, University of Southern California Keck School of Medicine, Los Angeles, CA, 90033, USA.
Clark C ChenDepartment of Neurosurgery, The Warren Alpert Medical School of Brown University, Providence, RI, 02903, USA.
Gabriel ZadaDepartment of Neurosurgery, University of Southern California Keck School of Medicine, Los Angeles, CA, 90033, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeMethylation of the O

methodsThe National Cancer Database was queried to identify all adult U.S. patients (≥ 18 years) diagnosed with IDH-wildtype GBM between 2018 and 2020. Treatment regimen was grouped into no chemotherapy and no radiotherapy, chemotherapy alone (without radiotherapy), radiotherapy alone (without chemotherapy), and chemoradiotherapy (chemotherapy and radiotherapy). Survival data were analyzed using Kaplan-Meier survival curves, log-rank tests, and multivariable Cox proportional hazard modeling.

resultsA total of 20,734 patients were included, of whom 6,404 (30.9%) had MGMT-methylated GBM, 9,065 (43.7%) had MGMT-unmethylated tumors, and 5,265 (25.4%) had unknown methylation status. The median and three-year overall survival were 12.4 months and 15.5%, respectively, for the entire cohort (16.4 months and 23.9% for MGMT-methylated patients and 11.8 months and 9.8% for MGMT-unmethylated patients, p < 0.001). Chemoradiotherapy was less commonly used for elderly (≥ 70 years, 58.5%) than non-elderly (< 70 years, 79.2%) patients. Among elderly patients, radiotherapy alone was more commonly administered than chemotherapy alone for patients with MGMT-unmethylated tumors (11.2% vs. 2.1%) and MGMT-methylated tumors (6.6% vs. 3.9%). However, chemotherapy alone was associated with a lower mortality risk (HR 0.71, 95% CI 0.51-0.99, p = 0.04) than radiotherapy alone for elderly patients with MGMT-methylated tumors, while chemotherapy alone was associated with a higher mortality risk (HR 1.63, 95% CI 1.09-2.44, p = 0.02) than radiotherapy alone for elderly patients with MGMT-unmethylated tumors. Patients who were elderly, uninsured, insured through Medicaid, lived in zip codes with lower median education levels, or received care at non-academic programs were less likely to undergo MGMT testing.

conclusionA high proportion of GBM patients in the United States undergo MGMT promoter testing, though significant sociodemographic disparities exist. While there was a decrease in chemoradiotherapy use with increasing age, radiotherapy alone was more commonly administered to elderly patients than chemotherapy alone irrespective of MGMT promoter methylation status.

Indexed as

Brain NeoplasmsDNA MethylationDNA Modification MethylasesDNA Repair EnzymesGlioblastomaTumor Suppressor ProteinsAdultAgedAged, 80 and overDatabases, FactualFemaleFollow-Up StudiesHumansIsocitrate DehydrogenaseMaleMiddle AgedDNA Modification MethylasesDNA Repair EnzymesIsocitrate DehydrogenaseMGMT protein, humanTumor Suppressor ProteinsGlioblastomaIDH wildtypeMGMTSurvival outcomesTreatment practices

Identifiers

PMID39907975
PMCPMC11968476

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.