Twenty-Year Survival In Glioblastoma: A Case Report And Molecular Profile.
Sperduto CM, Chakravarti A, Aldape K, Burger P, Papermaster GB, Sperduto P.
Int J Radiat Oncol Biol Phys. 2009 Mar 25.
Research Associate, Minneapolis Radiation Oncology,
Minneapolis, MN.
BACKGROUND: The prognosis for patients with glioblastoma
(GB) remains grim. Historically, the median survival has been 6 to 9 months.
Recent research has improved the outcome slightly. A computer search of the
literature reveals few long-term survivors. METHOD: Presented here is a case
report of a 20-year survivor of GB, with pathologic review to confirm the
diagnosis. A battery of molecular studies was performed to develop a molecular
profile of this unique patient. RESULTS: The results of the molecular genetic
testing for this most unusual patient were as follows: (1) methylguanine
methyl transferase (MGMT) was methylated, (2) p53 positive, (3) PTEN tumor
suppressor gene positive, (4) protein kinase AKT (pAKT) negative, and (5)
epidermal growth factor receptor negative. CONCLUSION: To our knowledge, this
is the longest survival of any patient in the literature whose initial
diagnosis was GB. Triple-positive GBM patients (MGMT methylated, PTEN, and p53
positive) are uncommon but may be associated with a better prognosis. Further
research is needed to confirm whether this molecular profile is prognostic of
prolonged survival. Molecular genetics will determine future treatment and
prognosis in GB.