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Meta-Analysis
. 2020 Mar 27;40(3):BSR20194127.
doi: 10.1042/BSR20194127.

Association between MGMT status and response to alkylating agents in patients with neuroendocrine neoplasms: a systematic review and meta-analysis

Zhirong Qi  1 , Huangying Tan  1
Affiliations
Meta-Analysis

Association between MGMT status and response to alkylating agents in patients with neuroendocrine neoplasms: a systematic review and meta-analysis

Zhirong Qi et al. Biosci Rep. .

Abstract

Background: O6-methylguanine-DNA methyltransferase (MGMT) is a specific DNA damage reversal repair protein. The influence of MGMT status on alkylating agent sensitivity in patients with neuroendocrine neoplasms (NENs) is controversial. We conducted a meta-analysis to assess the influence of MGMT status on the therapeutic sensitivity of alkylating agents in patients with NENs.

Methods: We searched PubMed, EmBase, and Cochrane library public databases through 3 July 2019. The objective response rate (ORR) was the outcome data of interest. Subgroup analysis was performed according based on MGMT methylation and expression of MGMT protein.

Results: Eleven studies were included in the meta-analysis. The proportion of patients with NENs that achieved an ORR after alkylating agent treatment was higher in the MGMT-deficient group than the non-deficient group (OR: 5.00; 95% CI: 3.04-8.22; P < 0.001; I2: 3%). Similar results were noted in the MGMT methylation and MGMT protein expression subgroups.

Conclusion: Patients with NENs and MGMT methylation or low protein expression had a higher ORR proportion than patients without MGMT methylation or high protein expression. The MGMT status can be used as a biological indicator of the response to alkylating agent treatment in patients with NENs.

Keywords: O6-methylguanine-DNA methyltransferase; alkylating agents; meta-analysis; neuroendocrine neoplasms.

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Conflict of interest statement

The authors declare that there are no competing interests associated with the manuscript.

Figures

Figure 1
Figure 1. PRISMA flow chart illustrating the selection of studies included in our analysis
Figure 2
Figure 2. Forest plot of ORR results comparing MGMT deficient and non-MGMT deficient patients with NENs after alkylating agent treatment
Figure 3
Figure 3. The funnel plot for assessing potential publication
Figure 4
Figure 4. Subgroup analysis of ORR results according to MGMT protein expression (subgroup 1) and detection of MGMT methylation (subgroup 2)
See this image and copyright information in PMC

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