Glioblastoma, IDH-Wildtype

This single-center retrospective study investigated the prognostic impact of MGMT promoter methylation and TERT promoter mutations in 54 patients with WHO grade 4 glioblastoma. The findings indicate that MGMT methylation is independently associated with improved overall survival, whereas TERT mutations predict worse survival. Adjuvant chemoradiotherapy was also confirmed to improve outcomes. A combined stratification using both biomarkers allows for the identification of four distinct prognostic subgroups, with MGMT-methylated/TERT-wild-type patients exhibiting the longest survival.

This study compared clinical characteristics and survival between molecularly defined IDH-wild-type glioblastoma (MolGBM) and histologically defined IDH-wild-type glioblastoma (HistGBM). It also characterized lower-grade IDH-wild-type astrocytic tumors lacking glioblastoma-defining genomic alterations. MolGBM exhibited a more favorable adjusted overall survival (HR 0.40) compared to HistGBM, particularly in patients aged 60 years or older. These findings highlight the clinical and biological heterogeneity among molecularly defined IDH-wild-type diffuse gliomas and the critical role of comprehensive molecular characterization. Lower-grade IDH-wild-type astrocytic tumors without glioblastoma-defining alterations warrant further in-depth molecular investigation.