Potent predictive CpG signature for temozolomide response in non-glioma-CpG island methylator phenotype glioblastomas with methylated MGMT promoter.

Glioblastomas that do not have the glioma-CpG island methylator phenotype (G-CIMP) but have a methylated promoter of the MGMT gene (meMGMT) show considerable variability in their response to temozolomide (TMZ). Powerful biomarkers that provide predictive information on optimal TMZ decision-making can be clinically useful. This study has identified and validated a panel of 77 TMZ efficacy-related CpGs and a seven-CpG risk signature for predicting TMZ usage in non-G-CIMP meMGMT glioblastomas. An integrated classification scheme is proposed for refining a MGMT-based TMZ-guiding approach in non-G-CIMP glioblastomas.