The DNA-Repair GeneMGMTand the Clinical Response of Gliomas to Alkylating Agents

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Abstract
Esteller and colleagues (Nov. 9 issue)1 claim that methylation of the O6-methylguanine-DNA methyltransferase (MGMT ) promoter is associated with improved responsiveness to carmustine and prolonged survival in patients with high-grade gliomas. We believe there are methodologic flaws in the authors' study that call these results into question. First, the patients in the study were treated with a combination of surgery, radiation therapy, and chemotherapy with cisplatin and carmustine. We do not believe the response to carmustine is a discernible end point in this trial, because multiple treatments were administered along with carmustine.