Prognostic Biomarkers in Glioblastoma: ASystematic Review and Meta-Analysis

Glioblastoma (GBM) is one of the highly aggressive cancers,yet the most common malignant brain tumor. GBM is characterizedby extensive heterogeneity at the cellular level, whichis also exemplified in its old name ‘glioblastoma multiform'.This heterogeneity is reflected in genomic aberrations and transcriptomicexpression, which adds to the complexity of treatingGBM. The extensive molecular annotation of cancer hasyielded many striking insights, including a greater awareness ofglobal epigenomic landscapes and the roles they play in drivingcell identity, phenotype, and neoplastic behavior. Those markersof epigenetic dysfunction now guide broader brain tumor diagnosticsis only the beginning. There are reliable biomarkers topredict the response and outcome of current or newly designedtherapies. While several molecular markers have been proposedas potential biomarkers for GBM, their uptake into clinical settingsis slow and impeded by marker heterogeneity. This studyaims to accurately evaluate the prognostic and predictive valueof biomarkers in clinical trial environments. Here we conducteda systematic review and meta-analysis to evaluate the prognosticand predictive significance of clinically relevant molecularbiomarkers in GBM patients. We also highlighted potential biomarkers,especially easily accessible circulating blood-basedmarkers, which, however, need a thorough future evaluationof their prognostic and/or predictive utility for GBM in certaintherapy settings. Our meta-analysis confirms the positive prognosticsignificance of MGMT methylation and IDH۱ mutationin GBM patients. The prognostic significance of EGFR amplification and overexpression still needs clarification. The largerand more pressing task that remains is to effectively characterizethe molecular mechanisms induced by epigenetic dysfunctionin these key oncogenic contexts and translate this knowledgeinto more effective treatment strategies to increase globalsurvival and quality of life in glioblastoma patients.

کلیدواژه ها:

glioblastoma ، prognostic biomarkers ، blood-basedmarkers ، IDH ، MGMT