Gliomas are the most common type of adult primary brain tumours. High grade gliomas (grade III and IV) are fast growing and aggressive forms of glioma, with standard treatment involving surgery and chemoradiation therapies.
Tumour markers are like unique fingerprints of natural and mutated proteins. Knowing which tumour markers are present helps to identify the treatment that the tumour will most likely respond to. Hence, it is important for patients and doctors to take tumour marker information into consideration when choosing the personalised therapy, to increase the chances of successful treatment and longer survival.
What was not known about the role of tumour markers in the Asian population?
Several international research studies in other countries have shown that the presence of tumour markers is linked to better treatment response and prolonged survival in glioma patients.
However, Western and Asian patients are known to have distinct differences in terms of incidence, risk factors, genetic susceptibility and sensitivity to treatments.
We wanted to ascertain if these survival benefits observed in other patient populations would equally apply to local Asian patients with high grade glioma (grade III and IV). We studied four molecular tumour markers in brain cancer patients in Singapore, and how these markers are related to overall survival.
Which tumour marker works for our Asian population?
MGMT methylation was present in 55% of our patients with grade III glioma and 30%, grade IV. These are comparable to globally reported rates in other studies.
More importantly, being MGMT positive was associated with increased overall survival in our cohort of patients. Besides MGMT methylation, younger age and having surgical treatment were factors that increased the odds of overall survival.
“We can use these tumour markers to guide decisions about personalised therapy for each individual” explained Dr Nicolas Kon, senior author on the study and a neurosurgeon at Mount Elizabeth Hospital, Singapore who performs brain tumour surgery.
The is the first published study about the incidence of different tumour markers among patients with high grade glioma in Singapore. We find that those who are MGMT positive lived longer than those who are negative. Having this information helps doctors to identify patients who have a better chance of responding to certain treatment, and guide personalised therapy for high grade glioma.