Review Article

Diagnostic and Therapeutic Biomarkers in Glioblastoma: Current Status and Future Perspectives

Table 2

Major biomarkers relevant to the management of patients with glioblastoma.

Type of biomarkerEGFR mutation/
amplification
MGMT promotor methylationIDH1/IDH2 mutationImagingReference

DiagnosticEGFRvIII highly correlates with glioma subtypes.
Real-time monitoring via typing of microvesicles with EGFR specific RNA.
Help to distinguish true progression and pseudoprogression in patients with newly diagnosed GBM treated with surgery followed by radiochemotherapy.Differentiate between primary and secondary GBM.
IDH-mutant diffuse gliomas and nonanaplastic reactive gliosis distinction.
Detection of specific molecular abnormalities.
For example, EGFRvIII, MGMT promotor methylation, and 2-HG which correlates with IDH mutation.
[9, 76, 112115, 118120, 131134]

Development status+/under evaluationUnder evaluation++

PrognosticBetter prognosis with 
(i) EGFRvIII + Ki64 20% or less, 
(ii) EGFRvIII + normal PTEN, 
(iii) EGFRvIII + methylated MGMT promotor.
Better OS and PFS (probably with IDH mutations) in malignant gliomas treated with radio- and/or chemotherapy.Better OS and PFSMRI: extent of tumor edema and necrosis has negative correlation with OS.
PET: 11C-MET uptake is associated with poorer patient survival.
[3236, 43, 44, 76, 78, 83, 85, 93, 126, 135140]

Development status+/under evaluation++Under evaluation

PredictivePossible biomarker for vaccine-based treatment.Predicts response to chemotherapy with alkylation agents and radiotherapy.
Correlate with better response to TMZ in
(i) newly diagnosed GBM with TMZ as a first-line treatment,
(ii) recurrent GBM,
(iii) elderly patients.
IDH1 mutation is independently associated with complete resection in patients with malignant gliomas treated with surgery.
 Complete surgical resection is associated with improved survival in patients with IDH1 mutation.
Absence of mutation suggests predictive role of MGMT promotor methylation for PFS in patients treated with chemotherapy.
Functional Diffusion Maps (fDMs) predicts PFS and OS in patients treated with radiochemotherapy.  
ADC predicts better response to bevacizumab combined with chemotherapy.
Association between hypoxia level (measured by 18F-FIMSO and radiotherapy response.
[77, 8691, 93, 122, 123, 136, 140, 141]

Development statusUnder evaluation+Under evaluationUnder evaluation

OS, overall survival; PFS, progression-free survival.