Separating the bad from the worst.

June 12, 2016. When it comes to GBM, knowing how to treat can be easier than knowing when to treat. Last week’s JAMA Onc pub reanalyzed 294 of 833 RTOG 0525 path specimens to measure 22 proteins involved with GBM pathogenesis. Six were significant on single-marker modeling: pAKT, pmTOR, survivin, Ki-67, c-Met, and MGMT. These protein expressions were further scrutinized to generate a new and improved NRG-GBM-RPA which found a combo of age along with MGMT protein (different than methylation status) and c-Met protein expressions to be most predictive of outcome--above and beyond the currently-used GBM-RPA. This new model was then independently validated on 176 Dutch GBM samples using simple IHC staining. In the molecular era, oncologists have much more than a microscope at our disposal so it's time we use all of our resources. And a GBM oncotype seems like a good place to start.