Association of patterns of care, prognostic factors, and use of radiotherapy–temozolomide therapy with survival in patients with newly diagnosed glioblastoma: a French national population-based study

Fabbro‐Peray, Pascale; Zouaoui, Sonia; Darlix, Amélie; Fabbro, Michel; Pallud, Johan; Rigau, Valérie; Mathieu-Daude, Hélène; Bessaoud, Faïza; Bauchet, Fabienne; Riondel, Adeline; Sorbets, Elodie; Charissoux, M.; Amelot, Aymeric; Mandonnet, Emmanuel; Figarella‐Branger, Dominique; Duffau, Hugues; Trétarre, Brigitte; Taillandier, Luc; Bauchet, Luc

doi:10.1007/s11060-018-03065-z

Cited by 69 publications

(58 citation statements)

References 42 publications

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“…2 ). Seven populations had 2-year survival available at both the earlier and later periods, enabling within-population comparisons: Surveillance, Epidemiology, and End Results (SEER) in the US 13 , 31 , Veterans Health Administration (VA) in the US 15 , Italy 26 , 35 , Switzerland 18 , 28 , France 9 , 17 , Sweden 16 , 24 and Korea 22 . The survival estimates were higher during the later period compared with the earlier period in all seven populations.…”

Section: Resultsmentioning

confidence: 99%

Longer-term (≥ 2 years) survival in patients with glioblastoma in population-based studies pre- and post-2005: a systematic review and meta-analysis

Poon

Sudlow

Figueroa

et al. 2020

Sci Rep

211

128

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Translation of survival benefits observed in glioblastoma clinical trials to populations and to longerterm survival remains uncertain. We aimed to assess if ≥ 2-year survival has changed in relation to the trial of radiotherapy plus concomitant and adjuvant temozolomide published in 2005. We searched MEDLINE and Embase for population-based studies with ≥ 50 patients published after 2002 reporting survival at ≥ 2 years following glioblastoma diagnosis. Primary endpoints were survival at 2-, 3-and 5-years stratified by recruitment period. We meta-analysed survival estimates using a random effects model stratified according to whether recruitment ended before 2005 (earlier) or started during or after 2005 (later). PROSPERO registration number CRD42019130035. Twentythree populations from 63 potentially eligible studies contributed to the meta-analyses. Pooled 2-year overall survival estimates for the earlier and later study periods were 9% (95% confidence interval [CI] 6-12%; n/N = 1,488/17,507) and 18% (95% CI 14-22%; n/N = 5,670/32,390), respectively. Similarly, pooled 3-year survival estimates increased from 4% (95% CI 2-6%; n/N = 325/10,556) to 11% (95% CI 9-14%; n/N = 1900/16,397). One study with a within-population comparison showed similar improvement in survival among the older population. Pooled 5-year survival estimates were 3% (95% CI 1-5%; n/N = 401/14,919) and 4% (95% CI 2-5%; n/N = 1,291/28,748) for the earlier and later periods, respectively. Meta-analyses of real-world data suggested a doubling of 2-and 3-year survival in glioblastoma patients since 2005. However, 5-year survival remains poor with no apparent improvement. Detailed clinically annotated population-based data and further molecular characterization of longer-term survivors may explain the unchanged survival beyond 5 years. Glioblastoma multiforme is the most common primary malignant brain tumour in adults with an incidence rate of 3.7 per 100,000 person-years, though geographical variation exists 1. Despite an increasing understanding of the underlying pathophysiology, glioblastoma remains an incurable disease with high mortality 2. A landmark clinical trial in 2005 demonstrated that the addition of concomitant and adjuvant temozolomide to radiotherapy provided an additional survival benefit to patients diagnosed with glioblastoma 3. Multiple clinical trials had investigated novel therapies that showed promise in pre-clinical and early phase studies, but to date there have been no major additions to the treatment armamentarium for newly diagnosed patients since 2005. The median survival in the intervention arm of the 2005 trial was 14.6 months 3 , but there is uncertainty about whether survival benefit from clinical trials is translated to the population 4,5. Clinical trial participation itself is associated with better survival 6 , which may be caused by the preferential inclusion and exclusion criteria into clinical trials. In clinical practice not all patients are eligible for the trial standard of care involving maximal surgical debul...

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Section: Resultsmentioning

confidence: 99%

Longer-term (≥ 2 years) survival in patients with glioblastoma in population-based studies pre- and post-2005: a systematic review and meta-analysis

Poon

Sudlow

Figueroa

et al. 2020

Sci Rep

211

128

View full text Add to dashboard Cite

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“…In addition to promising new drug delivery materials, the optimal therapeutic regimen is being determined. A study analyzed data from the French Brain Tumor DataBase, compared to standard 6 cycles, patients received adjuvant TMZ beyond 6 cycles had improved survival [ 31 ]. The delay in the initiation of chemotherapy and radiation following resection longer than 6 weeks was associated with worse OS [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical features associated with the efficacy of chemotherapy in patients with glioblastoma (GBM): a surveillance, epidemiology, and end results (SEER) analysis

2021

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Background Glioblastoma (GBM) is a highly malignant brain tumor with poor survival and prognosis. Randomized trials have demonstrated that chemotherapy improves survival in patients with GBM. This study aims to examine the clinical characteristics that are potentially associated with the efficacy of chemotherapy and the risk factors of GBM. Methods A total of 25,698 patients diagnosed with GBM were identified between 2004 and 2015 from the Surveillance, Epidemiology, and End Results (SEER). The clinical and demographic variables between groups were examined by Student’s t-test and Pearson’s chi-square test. GBM-specific survival (GBMSS) and overall survival (OS) were evaluated using the Kaplan-Meier method with the log-rank test. Univariable and multivariable analyses were also performed using the Cox proportional hazards model to identify statistically significant prognostic factors. Results Patients who received chemotherapy had better overall survival (median OS 13 vs. Three months, HR = 1.9224, 95%CI 1.8571–1.9900, p < 0.0001) and better GBMSS (median GBMSS of 12 vs. Three months, HR = 1.9379, 95%CI 1.8632–2.0156, p < 0.0001), compared to patients who did not. Further subgroup analysis revealed that among patients who underwent chemotherapy, those who were younger, with a supratentorial tumor, received surgery, or radiotherapy had both improved OS and GBMSS. Age, race, tumor location, tumor size, and treatments were identified as independent prognostic factors by multivariable analyses for patients with glioblastoma. Conclusion Patients with GBM who were younger (< 65 years), underwent surgery, or radiotherapy can benefit more from chemotherapeutic regimens. Age, race, tumor size, tumor location, surgery, radiotherapy, and chemotherapy were factors associated with the prognosis of patients with GBM.

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“…Median OS for the patients included in the FGB ( n = 915) is 24.2 months. This median OS is significantly longer than that for the patients in two other GB cohorts: TCGA-GB (http://www.cancergenome.nih.gov/; n = 486; 12.5 months) and the French brain tumor database (FBTDB; n = 1936; 11.2 months) [11] ( P < 0.001) (Fig. 2).…”

Section: Resultsmentioning

confidence: 90%

“…In particular, advanced surgical techniques have been developed for optimal safe resection. Another possible explanation is that the FGB cohort contains only a small percentage of patients who have undergone biopsy (13.3% vs. 41.2% in the FBTDB) [11] because this surgical procedure results in the collection of insufficient tumor tissue for cryopreservation.…”

Section: Discussionmentioning

confidence: 99%

The French glioblastoma biobank (FGB): a national clinicobiological database

et al. 2019

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Background Glioblastomas (GB) are the most common and lethal primary brain tumors. Significant progress has been made toward identifying potential risk factors for GB and diagnostic and prognostic biomarkers. However, the current standard of care for newly diagnosed GB, the Stupp protocol, has remained unchanged for over a decade. Large-scale translational programs based on a large clinicobiological database are required to improve our understanding of GB biology, potentially facilitating the development of personalized and specifically targeted therapies. With this goal in mind, a well-annotated clinicobiological database housing data and samples from GB patients has been set up in France: the French GB biobank (FGB). Methods The biobank contains data and samples from adult GB patients from 24 centers in France providing written informed consent. Clinical and biomaterial data are stored in anonymized certified electronic case report forms. Biological samples (including frozen and formalin-fixed paraffin-embedded tumor tissues, blood samples, and hair) are conserved in certified biological resource centers or tumor tissue banks at each participating center. Results Clinical data and biological materials have been collected for 1087 GB patients. A complete set of samples (tumor, blood and hair) is available for 66%, and at least one frozen tumor sample is available for 88% of the GB patients. Conclusions This large biobank is unique in Europe and can support the large-scale translational projects required to improve GB care. Additional biological materials, such as peritumoral brain zone and fecal samples, will be collected in the future, to respond to research needs.

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Association of patterns of care, prognostic factors, and use of radiotherapy–temozolomide therapy with survival in patients with newly diagnosed glioblastoma: a French national population-based study

Cited by 69 publications

References 42 publications

Longer-term (≥ 2 years) survival in patients with glioblastoma in population-based studies pre- and post-2005: a systematic review and meta-analysis

Longer-term (≥ 2 years) survival in patients with glioblastoma in population-based studies pre- and post-2005: a systematic review and meta-analysis

Clinical features associated with the efficacy of chemotherapy in patients with glioblastoma (GBM): a surveillance, epidemiology, and end results (SEER) analysis

The French glioblastoma biobank (FGB): a national clinicobiological database

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