A survival analysis of GBM patients in the West of Scotland pre- and post-introduction of the Stupp regime

Teo, Mario; Martin, Sean; Agyemang, Kevin; Nowicki, Stefan; Clark, Brian; Mackinnon, Mairi; Stewart, William; Paul, James; George, Jerome St

doi:10.3109/02688697.2013.847170

Cited by 24 publications

(16 citation statements)

References 12 publications

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“…The treatment rates increased over time. An observation in our data was that patients with lower performance status according to Karnofsky seemed less likely both to start and complete treatment according to Stupp, which is consistent with clinical practice and studies …”

Section: Discussionsupporting

confidence: 90%

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Improved survival of Swedish glioblastoma patients treated according to Stupp

et al. 2018

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Section: Discussionsupporting

confidence: 90%

“…The patients in our cohort are unselected and include all consecutive cases, which may be 1 explanation to the differences. The median overall survival in patients treated with the Stupp protocol in the cohort 2006‐2012 is comparable to the survival of treated patients in another Scottish study …”

Section: Discussionsupporting

confidence: 52%

Improved survival of Swedish glioblastoma patients treated according to Stupp

et al. 2018

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“…33 Younger patients depict a longer survival time. 34 Our findings support the notion that increasing age shows a decreasing OS; we found an incremental hazard of death per year of age of 6%.…”

supporting

confidence: 81%

Choline-to-N-acetyl aspartate and lipids-lactate-to-creatine ratios together with age assemble a significant Cox's proportional-hazards regression model for prediction of survival in high-grade gliomas

Roldan-Valadez¹,

Rı́os

Motola-Kuba³

et al. 2016

BJR

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S. Choline-to-N-acetyl aspartate and lipids-lactate-tocreatine ratios together with age assemble a significant Cox's proportional-hazards regression model for prediction of survival in high-grade gliomas. Br J Radiol 2016; 89: 20150502. FULL PAPERCholine-to-N-acetyl aspartate and lipids-lactate-to-creatine ratios together with age assemble a significant Cox's proportional-hazards regression model for prediction of survival in high-grade gliomas Objective: A long-lasting concern has prevailed for the identification of predictive biomarkers for high-grade gliomas (HGGs) using MRI. However, a consensus of which imaging parameters assemble a significant survival model is still missing in the literature; we investigated the significant positive or negative contribution of several MR biomarkers in this tumour prognosis. Methods: A retrospective cohort of supratentorial HGGs [11 glioblastoma multiforme (GBM) and 17 anaplastic astrocytomas] included 28 patients (9 females and 19 males, respectively, with a mean age of 50.4 years, standard deviation: 16.28 years; range: 13-85 years). Oedema and viable tumour measurements were acquired using regions of interest in T 1 weighted, T 2 weighted, fluid-attenuated inversion recovery, apparent diffusion coefficient (ADC) and MR spectroscopy (MRS). We calculated Kaplan-Meier curves and obtained Cox's proportional hazards.Results: During the follow-up period (3-98 months), 17 deaths were recorded. The median survival time was 1.73 years (range, 0.287-8.947 years). Only 3 out of 20 covariates (choline-to-N-acetyl aspartate and lipids-lactate-to-creatine ratios and age) showed significance in explaining the variability in the survival hazards model; score test: x 2 (3) 5 9.098, p 5 0.028. Conclusion: MRS metabolites overcome volumetric parameters of peritumoral oedema and viable tumour, as well as tumour region ADC measurements. Specific MRS ratios (Cho/Naa, L-L/Cr) might be considered in a regular follow-up for these tumours. Advances in knowledge: Cho/Naa ratio is the strongest survival predictor with a log-hazard function of 2.672 in GBM. Low levels of lipids-lactate/Cr ratio represent up to a 41.6% reduction in the risk of death in GBM.

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“…Current standard treatment for GBM is palliative in nature, typically involving de-bulking surgery followed by radiotherapy and DNA-alkylating chemotherapeutic agents to eliminate the remaining cells. The recent introduction of the Stupp protocol combining radiation therapy with adjuvant chemotherapeutic agent temozolomide (TMZ) has improved GBM 5 year survival from 2% to approximately 10% [2, 3]. However, prognosis for GBM patients remains extremely poor despite these advances, with median survival reported at 14.6 months [2, 4].…”

Section: Introductionmentioning

confidence: 99%

β-escin selectively targets the glioblastoma-initiating cell population and reduces cell viability

2016

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Glioblastoma multiforme (GBM) is a highly aggressive tumour of the central nervous system and is associated with an extremely poor prognosis. Within GBM exists a subpopulation of cells, glioblastoma-initiating cells (GIC), which possess the characteristics of progenitor cells, have the ability to initiate tumour growth and resist to current treatment strategies. We aimed at identifying novel specific inhibitors of GIC expansion through use of a large-scale chemical screen of approved small molecules. Here, we report the identification of the natural compound β-escin as a selective inhibitor of GIC viability. Indeed, β-escin was significantly cytotoxic in nine patient-derived GIC, whilst exhibiting no substantial effect on the other human cancer or control cell lines tested. In addition, β-escin was more effective at reducing GIC growth than current clinically used cytotoxic agents. We further show that β-escin triggers caspase-dependent cell death combined with a loss of stemness properties. However, blocking apoptosis could not rescue the β-escin-induced reduction in sphere formation or stemness marker activity, indicating that β-escin directly modifies the stem identity of GIC, independent of the induction of cell death. Thus, this study has repositioned β-escin as a promising potential candidate to selectively target the aggressive population of initiating cells within GBM.

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A survival analysis of GBM patients in the West of Scotland pre- and post-introduction of the Stupp regime

Abstract: Significant survival benefit has been achieved, following the introduction of the Stupp regime, in GBM patients in the West of Scotland.

Cited by 24 publications

References 12 publications

Improved survival of Swedish glioblastoma patients treated according to Stupp

Improved survival of Swedish glioblastoma patients treated according to Stupp

Choline-to-N-acetyl aspartate and lipids-lactate-to-creatine ratios together with age assemble a significant Cox's proportional-hazards regression model for prediction of survival in high-grade gliomas

β-escin selectively targets the glioblastoma-initiating cell population and reduces cell viability

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