Order Code LABMGMT MGMT Promoter Methylation Analysis, Tumor

Additional Codes

Mayo Test Code: MGMTD
EPIC Test Code: LABMGMT

Necessary Information

A pathology report (final or preliminary), containing the following information, is required and must accompany specimen for testing to be performed:

1. Patient name

2. Block number-must be on all blocks, slides, and paperwork (can be handwritten on the paperwork)

3. Tissue collection date

4. Source of the tissue

Specimen Required

This assay requires at least 20% tumor nuclei.

-Preferred amount of tumor area with sufficient percent tumor nuclei: tissue 144 mm(2) tissue (4 x 6 mm x 6 mm areas)

-Minimum amount of tumor area: 36 mm(2) tissue (1 x 6 mm x 6 mm area)

-These amounts are cumulative over up to 10 unstained slides and must have adequate percent tumor nuclei.

-Tissue fixation: formalin-fixed paraffin-embedded (FFPE), non-decalcified

Submit only 1 of the following specimens:

Specimen Type: Tissue block

Collection Instructions: Submit a formalin-fixed non-decalcified, paraffin-embedded tissue block.

Specimen Type: Tissue slide

Slides: 1 Stained and 10 unstained

Collection Instructions: Submit 1 slide stained with hematoxylin and eosin and 10 unstained, nonbaked slides with 5-micron thick sections of the tumor tissue.

Note: The total amount of required tumor nuclei can be obtained by scraping up to 10 slides from the same block.

Useful For

Prognostication of newly diagnosed patients with glioblastoma

Identification of newly diagnosed glioblastoma patients that may derive benefit from alkylating chemotherapy (ie, temozolomide)

Therapy selection for newly diagnosed glioblastoma in older patients (>60-65 years)

Additional Tests

Test ID	Reporting Name	Available Separately	Always Performed
SLIRV	Slide Review in MG	No, (Bill Only)	Yes

Testing Algorithm

When this test is ordered, slide review will always be performed at an additional charge.

Method Name

Droplet Digital Polymerase Chain Reaction (ddPCR)

Reporting Name

MGMT Promoter Methylation Analysis

Specimen Type

Varies

Specimen Minimum Volume

5 unstained slides at 5-microns thickness

Specimen Stability Information

Specimen Type	Temperature	Time
Varies	Ambient (preferred)
	Refrigerated

Reject Due To

Specimens that have been decalcified (all methods)
Specimens that have not been formalin-fixed, paraffin-embedded
Extracted nucleic acid (DNA/RNA)

Reject

Reference Values

An interpretive report will be provided.

Method Description

Droplet digital polymerase chain reaction using a TaqMan assay is performed on bisulfite converted DNA to evaluate for the presence of increased levels of methylation involving CpG sites 75-80 and 84-87 within the promoter region of the MGMT gene.(Unpublished Mayo method)

Day(s) Performed