Abstract
Quantitative methylation-specific tests suggest that not all cells in a glioblastoma with detectable promoter methylation of the O6-methylguanine DNA methyltransferase (MGMT) gene carry a methylated MGMT allele. This observation may indicate cell subpopulations with distinct MGMT status, raising the question of the clinically relevant cutoff of MGMT methylation therapy. Epigenetic silencing of the MGMT gene by promoter methylation blunts repair of O6-methyl guanine and has been shown to be a predictive factor for benefit from alkylating agent therapy in glioblastoma. Ten paired samples of glioblastoma and respective glioblastoma-derived spheres (GS), cultured under stem cell conditions, were analyzed for the degree and pattern of MGMT promoter methylation by methylation-specific clone sequencing, MGMT gene dosage, chromatin status, and respective effects on MGMT expression and MGMT activity. In glioblastoma, MGMT-methylated alleles ranged from 10% to 90%. In contrast, methylated alleles were highly enriched (100% of clones) in respective GS, even when 2 MGMT alleles were present, with 1 exception (<50%). The CpG methylation patterns were characteristic for each glioblastoma exhibiting 25% to 90% methylated CpGs of 28 sites interrogated. Furthermore, MGMT promoter methylation was associated with a nonpermissive chromatin status in accordance with very low MGMT transcript levels and undetectable MGMT activity. In MGMT-methylated glioblastoma, MGMT promoter methylation is highly enriched in GS that supposedly comprise glioma-initiating cells. Thus, even a low percentage of MGMT methylation measured in a glioblastoma sample may be relevant and predict benefit from an alkylating agent therapy.
Highlights
O6-Methylguanine-DNA methyltransferase (MGMT) is a cellular DNA repair protein ubiquitously expressed in normal human tissues [1]
methylguanine DNA methyltransferase (MGMT) promoter methylation was associated with a nonpermissive chromatin status in accordance with very low MGMT transcript levels and undetectable MGMT activity
In MGMT-methylated glioblastoma, MGMT promoter methylation is highly enriched in glioblastoma-derived spheres (GS) that supposedly comprise glioma-initiating cells
Summary
O6-Methylguanine-DNA methyltransferase (MGMT) is a cellular DNA repair protein ubiquitously expressed in normal human tissues [1]. The MGMT protein rapidly reverses alkylation (e.g., methylation) at the O6 position. Authors' Affiliations: 1Laboratory of Brain Tumor Biology and Genetics of the 2Service of Neurosurgery, Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne (UNIL), 3National Center of Competence in Research Molecular Oncology, ISREC-SV-EPFL, Lausanne,4Service of Neurosurgery, Centre Hospitalier du Centre du Valais, Sion, and 5Laboratory of Cytogenetics, Service of Medical Genetics, CHUV, UNIL, Lausanne, Switzerland; 6MDxHealth Inc. Liege; Belgium; 7Division of Neuropathology, CHUV UNIL, Lausanne, Switzerland; and 8Department of Toxicology, University Medical Center, Mainz, Germany. Note: Supplementary data for this article are available at Clinical Cancer Research Online (http://clincancerres.aacrjournals.org/). Of guanine, thereby neutralizing the cytotoxic effect of alkylating agents [2]. Expression of MGMT in tumor cells represents a key mechanism of resistance for alkylating agent therapy [3]
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