Monday, February 4, 2008
MGMT and MGMT promoter hypermethylation testing not ready for prime time
A few months ago, an oncologist at my institution asked for an MGMT promoter hypermethylation assay on a high grade glioma. I looked into the issue, and discovered that testing is not standardized yet and really not ready for clinical use. In a review article on molecular testing of gliomas in the January '08 issue of Journal of Neuropathology and Experimental Neurology, the authors concur with this position. That being said, if anyone does want to do immunohistochemistry (IHC) for MGMT, Dr. Roger McLendon at Duke performs this test. Some would argue that PCR is better than IHC, but the good Dr. McLendon counters that immunohistochemistry is more reliable as it correlates with enzyme activity while the PCR promoter methylation assay does not. In any case, I got the oncologist to cancel her request for MGMT promoter methylation studies.