Analytical Validation of the Belay Vantage™ Assay for Evaluation of MGMT Promoter Methylation Using Enzymatically Converted tumorDNA from Cerebrospinal Fluid

Authors:

Kala F Schilter, Qian Nie, Jennifer N Adams, Rakshitha Jagadish, Anthony Acevedo, Alexandra Larson, Samantha A Vo, Brett A Domagala, Kyle M Hernandez, Christopher Douville, Yuxuan Wang, Brian Coe, Chetan Bettegowda, Honey V Reddi

Journal:

Cancer Genetics. Volumes 294–295, June 2025, Pages 94-98

Abstract:

MGMT promoter methylation status (hypermethylation) is one of the strongest prognostic and predictive biomarkers in glioblastoma (GBM) and is associated with a more favorable response to alkylating chemotherapies such as Temozolomide (TMZ). Additionally, it is associated with pseudo progression in GBM, a phenomenon in which early radiographic changes after treatment are indicative of possible tumor recurrence though on histological examination it is consistent with treatment effect. Current methods for evaluation of MGMT promoter methylation status are limited to tumor tissue, requiring invasive biopsy or surgery, prompting the need for a liquid biopsy-based assay to expand and manage therapeutic interventions. The Belay Vantage™ assay evaluates MGMT promoter methylation status in cerebrospinal fluid (CSF) of individuals with known or suspected central nervous system tumors using low input DNA. The assay uses quantitative polymerase chain reaction (qPCR) on DNA extracted from CSF after enzymatic conversion and has an analytical sensitivity of 95.5 % and specificity of 100 %.