Studying Some Epigenetic Modifications In Glioblastoma Multiforme and Their Impact On Clinical Outcome

Objectives. Elucidate the potential role of methylation levels of the MGMT, NUPR1, NDRG2, and GLI1 genes as epigenetic markers for GBM through measuring and comparing the methylation levels of four genes in GBM and NND samples The study researchers started recruiting participants from September 2020 to October 2022, after receiving research ethical approvals from the Medical Ethical Committees at the National Research Center ID#20110 and from the Research Ethics Committee of Faculty of Pharmacy, Ain Shams University, Cairo, Egypt, serial no.[ENREC-ASU 2020-8].

Informed consents were signed by patients or their first-degree relatives. Study participants either patients or controls were informed with the study problem, aim, and objectives. The study was conducted in accordance with the Declaration of Helsinki Guidelines approved in 2013.

A total of 58 primary GBM treatment-naïve Egyptian patients were recruited from the Clinical Oncology Department, Faculty of Medicine, Ain Shams University Hospital, Cairo, Egypt.

Patients' Inclusion Criteria Adult patients (age > 18 years) with a recent diagnosis of GBM and had a performance level of less than or equal to 2 on the Ester Clinical Oncology Group (ECOG) scale .

Therapeutic Approaches, All GBM patients were evaluated clinically, through a full medical history, physical, and neurological examinations. Brain scan was done to enable the patient to receive standardized therapeutic protocol, which includes the greatest secured surgical removal (if attainable), followed by conventional fractionated radiotherapy (aggregate dosage of 60 gray (Gy), provided 2 Gy per fraction for 30 fractions during six weeks) or hypo-fractionated radiotherapy (45 Gy in 15 fractions during three weeks) alongside concurrent TMZ as chemotherapeutic agent in dose of 75 mg/m2 of body surface area daily until the completion of the radiation therapy with periodical follow-up, then re-evaluated clinically and radiologically, given an adjuvant therapy at total of six cycles of TMZ therapy at a dosage of 150 mg/m2 of body surface area from day one to five for a total of 28 days with closely medical surveillance.