"These results are important because temozolomide is a drug that acts directly against DNA to slow down the replication of cancer cells. So, it is bad news if the patient has non-methylated status because the DNA in these rogue cancer cells is being repaired as fast as the drug causes damage. This means the cancer cells are able to survive the drug's onslaught," said Dr. Hegi, who is also project leader at the national Centre of Competence in Research Molecular Oncology at ISREC in Epalinges, Switzerland. She said that the study was the first randomised trial to test MGMT methylation status in a large patient population. "The test will provide the opportunity to select patients that might profit from temozolomide. In other words, temozolomide can become a targeted treatment. It is a first step towards molecular diagnostics. In the future, biopsy material optimally conserved for molecular testing should be collected for all patients as a routine diagnostic procedure." It also meant, she added, that for patients without methylation, future clinical trials could be designed evaluating new treatments rather than treatments with temozolomide. Temozolomide would now certainly become the standard treatment for those patients whose tests predict that they would benefit from the drug.
Dr. Hegi said these results were important not only for patients who were likely to benefit, but also for those that were not. Even though the drug was well tolerated it still had inherent toxicity. Patients who were unlikely to respond could be spared side effects and possibly benefit from other treatments that would be more effective for them. Another drug called 06-Benzyl-guanine a substrate for the MGMT enzyme was currently being t
Contact: Margaret Willson
European Organisation for Research and Treatment of Cancer