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The aim of this study is to investigate the relationship between isocitrate dehydrogenase-1 ( IDH1 ) mutation and O 6 -methylguanine-DNA methyltransferase ( MGMT ) promoter methylation with recurrence-free interval in glioblastoma patients treated with chemoradiotherapies. Clinical data were collected from 82 patients with totally resected glioblastoma and treated with adjuvant therapies from 2014 to 2019.  IDH1  mutation was assessed by immunohistochemistry and  MGMT  promoter methylation was assessed by different sequencing methods.  IDH1  mutation was present in 32 cases and 50 cases were  IDH1  wildtype; 54 and 28 patients had unmethylated and methylated  MGMT  promoter, respectively, Of the 82 patients, 62 patients received chemoradiotherapy while 20 patients only received radiation. Approximately, 61% of patients had a tumor recurrence after 1 year, and 39% showed a recurrence before 1 year of treatment. There was no significant relationship between  IDH1  mutation and  MGMT  promoter methylation ( p -value = 0.972). Patients with  IDH1  mutation and their age <50 years showed a significant difference in recurrence-free interval ( p -value = 0.014). Difference in recurrence-free interval was also statistically observed in patients with unmethylated  MGMT  promoter and treated with chemoradiotherapies ( p -value = 0.031), by which they showed a late tumor recurrence ( p -value = 0.016). This revealed that  IDH1  mutation and  MGMT  methylation are independent prognostic factors in glioblastoma. Although  IDH1 -mutant glioblastomas showed late tumor recurrence in patients less than 50 years old, the type of treatment modalities may not show additional beneficial outcome. Patients with unmethylated  MGMT  and  IDH1  mutation, treated with different chemoradiotherapies, showed a late tumor recurrence.

pathology and oncology research

The Impact of IDH1 Mutation and MGMT Promoter Methylation on Recurrence-Free Interval in Glioblastoma Patients Treated With Radiotherapy and Chemotherapeutic Agents