Prognosis of glioblastoma patients improves significantly over time interrogating historical controls.

in European journal of cancer (Oxford, England : 1990) by A Thomas-Joulié, S Tran, L El Houari, A Seyve, F Bielle, C Birzu, F Lozano-Sanchez, K Mokhtari, M Giry, Y Marie, F Laigle-Donadey, C Dehais, C Houillier, D Psimaras, A Alentorn, A Laurenge, M Touat, M Sanson, K Hoang-Xuan, A Kas, L Rozenblum, M-O Habert, L Nichelli, D Leclercq, D Galanaud, J Jacob, C Karachi, L Capelle, A Carpentier, B Mathon, L Belin, A Idbaih

TLDR

  • The study looked at the survival rates of people with a type of brain cancer called GBM. They found that people who were diagnosed more recently had a longer survival rate than those who were diagnosed earlier. The study thinks that this increase in survival rate is because of better treatment and care for people with GBM, including better management of other health problems, better treatment options, and better support from doctors and caregivers. The study also suggests that clinical trials can help improve the treatment and care for people with GBM and increase their survival rate.

Abstract

Glioblastoma (GBM) is the most common devastating primary brain cancer in adults. In our clinical practice, median overall survival (mOS) of GBM patients seems increasing over time. To address this observation, we have retrospectively analyzed the prognosis of 722 newly diagnosed GBM patients, aged below 70, in good clinical conditions (i.e. Karnofsky Performance Status -KPS- above 70%) and treated in our department according to the standard of care (SOC) between 2005 and 2018. Patients were divided into two groups according to the year of diagnosis (group 1: from 2005 to 2012; group 2: from 2013 to 2018). Characteristics of patients and tumors of both groups were very similar regarding confounding factors (age, KPS, MGMT promoter methylation status and treatments). Follow-up time was fixed at 24 months to ensure comparable survival times between both groups. Group 1 patients had a mOS of 19 months ([17.3-21.3]) while mOS of group 2 patients was not reached. The recent period of diagnosis was significantly associated with a longer mOS in univariate analysis (HR=0.64, 95% CI [0.51 - 0.81]), p < 0.001). Multivariate Cox analysis showed that the period of diagnosis remained significantly prognostic after adjustment on confounding factors (adjusted Hazard Ratio (aHR) 0.49, 95% CI [0.36-0.67], p < 0.001). This increase of mOS over time in newly diagnosed GBM patients could be explained by better management of potentially associated non-neurological diseases, optimization of validated SOC, better management of treatments side effects, supportive care and participation in clinical trials.

Overview

  • The study retrospectively analyzed the prognosis of 722 newly diagnosed GBM patients, aged below 70, in good clinical conditions (KPS above 70%) and treated in the department according to the standard of care (SOC) between 2005 and 2018. The study aimed to investigate the increase in median overall survival (mOS) of GBM patients over time and identify the factors contributing to this increase. The study used a univariate and multivariate Cox analysis to analyze the data.

Comparative Analysis & Findings

  • The study found that the recent period of diagnosis was significantly associated with a longer mOS in univariate analysis (HR=0.64, 95% CI [0.51 - 0.81], p<0.001). The multivariate Cox analysis showed that the period of diagnosis remained significantly prognostic after adjustment on confounding factors (adjusted Hazard Ratio (aHR) 0.49, 95% CI [0.36-0.67], p<0.001). The study suggests that the increase in mOS over time in newly diagnosed GBM patients could be explained by better management of potentially associated non-neurological diseases, optimization of validated SOC, better management of treatments side effects, supportive care and participation in clinical trials.

Implications and Future Directions

  • The study's findings suggest that the increase in mOS over time in newly diagnosed GBM patients could be due to better management of non-neurological diseases, optimization of standard of care, better management of treatments side effects, supportive care, and participation in clinical trials. Future research should focus on identifying the specific factors contributing to this increase and developing interventions to improve the prognosis of GBM patients. The study also highlights the importance of clinical trials in improving the management of GBM and increasing the survival rate of patients.
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