There may be significant epigenetic heterogeneity at this particular locus, and progression from hypermethylated to hypomethylated MGMT promoter status in recurrent tumors may reflect the selection of existing hypomethylated MGMT cells and serve as a mechanism for further resistance to TMZ [ 25 , 156 ].
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Genetic and epigenetic instability as an underlying driver of progression and aggressive behavior in IDH-mutant astrocytoma.
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