MGMT promoter methylation

O6-methylguanine-DNA methyltransferase (MGMT) promoter methylation is an important biomarker because it is associated with reduced DNA repair capacity and increased sensitivity to alkylating agents, particularly temozolomide (TMZ)...Because MGMT methylation is biologically continuous, this review further argues that borderline results should be reported as gray-zone or intermediate categories when validated, and that quantitative methylation values should be integrated into subtype-aware multivariable models rather than being reduced exclusively to binary calls. This review summarizes the biological and clinical relevance of MGMT promoter methylation across glioma subtypes and proposes a subtype-aware, treatment-conditional, and assay-aware framework for interpreting its predictive and survival-related significance.

Furthermore, static magnetic fields have been reported to increase apoptosis, inhibit proliferation, and may offer a complementary treatment with low toxicity. These findings suggest that magnetic-field-based approaches offer an innovative strategy for GBM treatment.

Emerging applications in other cancer types are also summarized and discussed. Throughout the review the focus is more on a critical discussion of concepts and relevant publications and their merits and shortcomings than trying to achieve complete coverage of the voluminous literature.

qDMA-HP is comparable to pyrosequencing in prognostic effectiveness but is simpler and more cost-effective, suggesting its potential for broad clinical use.

We retrospectively analyzed 20 patients with newly diagnosed primary IDH-wildtype glioblastoma who underwent gross-total resection followed by standard radiotherapy and temozolomide treatment between 2016 and 2022...However, given the limited sample size, the selection of extreme survival groups, and the predominance of chromosomal polysomy detected by FISH, these findings should be interpreted as hypothesis-generating only. Further validation in larger cohorts using high-resolution genomic methods is warranted.

In parallel, artificial intelligence and machine learning are advancing the field by integrating multi-omics and radiomic data to enhance detection, classify tumors, and predict key molecular alterations, supporting the emerging framework of radiogenomics. Together, these developments are driving a shift toward more precise and dynamic approaches to brain tumor diagnosis and management, with relevance for improving outcomes in older adults with brain cancer.

Glioblastoma multiforme (GBM) is the most aggressive primary brain tumor in adults, with a median survival of 14.6 months under standard radiotherapy and temozolomide (TMZ) chemotherapy...Transfer learning improved generalization across train/test distributions at the cost of peak performance. These findings suggest, for the tested framework in this study, that MGMT methylation status prediction from mpMRI remains fundamentally constrained by dataset heterogeneity and size, irrespective of modality combination strategy, and that T2w coronal acquisitions could be more interesting in future data collection efforts.

MGMT encodes a DNA repair enzyme that removes cytotoxic O⁶-alkylguanine lesions generated by alkylating agents such as temozolomide (TMZ)...Building on these mechanistic insights, this review discusses emerging strategies to overcome MGMT-mediated resistance, including next-generation alkylating agents, epigenetic modulators, combination immunotherapies, and radiogenomic approaches for precision medicine. Understanding MGMT methylation biology may improve patient stratification and support precision-based therapeutic interventions in GBM.

SFRT was associated with longer survival in non-elderly patients, possibly reflecting selection of poorer-risk patients for HFRT. In elderly patients, HFRT was noninferior regardless of MGMTp status, supporting its use as a less intensive approach with comparable survival and reduced treatment burden.

Additionally, the manuscript emphasizes novel therapeutic strategies, such as nanomedicine, oncolytic virotherapy, immunotherapy, tumor-treating fields, and phytochemical-based interventions, as well as the increasing significance of artificial intelligence and machine learning in diagnosis and personalized treatment. Lastly, this review integrates mechanistic and translational insights to establish a framework addressing blood-brain barrier limitations, therapeutic resistance, and immune evasion, thereby facilitating the advancement of precision medicine approaches for enhanced GBM outcomes.

Radial transition analysis using the Mann-Whitney U-test demonstrated that transition slopes between the T1-weighted contrast-enhancing and T2/FLAIR hyperintense regions, as well as between the T2/FLAIR hyperintense and peritumoral regions, were significantly associated with biomarker status. Radiomic features extracted from spherical surfaces at varying radial distances from the tumor centroid demonstrate stronger associations with key molecular markers and patient survival compared to conventional Euclidean radiomics, highlighting the value of spatially structured radiomic analysis for improved GBM characterization.

This international clinical dataset of adults diagnosed with glioblastoma since the introduction of the WHO CNS 5 criteria supports the use of conventionally fractionated chemoradiation in fit patients < 70, while hypofractionated regimens are appropriate for those ≥ 70. Surgical extent, treatment intensity, and MGMT methylation remain key determinants of survival in older patients with glioblastoma.