MGMT testing—the challenges for biomarker-based glioma treatment

The DNA repair protein O6-methylguanine-DNA methyltransferase (MGMT) might interfere with alkylating agent chemotherapy in patients with glioma or glioblastoma. In this Review, Wick and colleagues discuss how epigenetic silencing of the MGMT gene via promotor methylation is associated with improved response to chemotherapy, and with improved survival, in patients with glioblastoma and other gliomas. The authors also highlight the usefulness of MGMT promotor methylation as a biomarker for both clinical practice and the design of treatment trials.