Treatment of newly diagnosed glioblastoma in the elderly: a network meta-analysis

Abstract

BackgroundA glioblastoma is a fatal type of brain tumour for which the standard of care is maximum surgical resection followed by chemoradiotherapy, when possible. Age is an important consideration in this disease, as older age is associated with shorter survival and a higher risk of treatment-related toxicity. ObjectivesTo determine the most e ective and best-tolerated approaches for the treatment of elderly people with newly diagnosed glioblastoma. To summarise current evidence for the incremental resource use, utilities, costs and cost-e ectiveness associated with these approaches. Search methodsWe searched electronic databases including the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and Embase to 3 April 2019, and the NHS Economic Evaluation Database (EED) up to database closure. We handsearched clinical trial registries and selected neuro-oncology society conference proceedings from the past five years. Selection criteriaRandomised trials (RCTs) of treatments for glioblastoma in elderly people. We defined 'elderly' as 70+ years but included studies defining 'elderly' as over 65+ years if so reported. Data collection and analysisWe used standard Cochrane methods for study selection and data extraction. Where su icient data were available, treatment options were compared in a network meta-analysis (NMA) using Stata so ware (version 15.1). For outcomes with insu icient data for NMA, pairwise meta-analysis were conducted in RevMan. The GRADE approach was used to grade the evidence.Treatment of newly diagnosed glioblastoma in the elderly: a network meta-analysis (Review)

Global post-marketing safety surveillance of Tumor Treating Fields (TTFields) in patients with high-grade glioma in clinical practice

“…TTFields treatment of elderly patient with ndGBM has been described as promising, since TTFields plus adjuvant chemotherapy compared with chemotherapy alone suggests improved OS in elderly patients with ndGBM. However, further evidence on QoL and tolerability in elderly patients is needed [34]. Our real-world evidence of evaluated safety/ tolerability data for TTFields in elderly patients with GBM aids in defining unmet needs in this select population.…”

AEBP1 Promotes Glioblastoma Progression and Activates the Classical NF-κB Pathway

“…GBM is one of the deadliest diseases of the central nervous system, and the survival rate and life expectancy of GBM patients are bleak [ 1 , 2 ]. Despite great advances in understanding the genetic basis of gliomas, little progress has been made in exploring the molecular mechanisms underlying their malignant progression [ 16 ].…”

“…Glioblastoma (GBM) is a common primary malignant brain tumor in adults. Known as a very aggressive brain cancer, it is one of the most lethal malignancies in humans [ 1 , 2 ]. At present, the prognosis of patients with GBM remains very poor, with a median survival time of 15 months [ 3 , 4 ].…”

Tumor‐associated macrophages as treatment targets in glioma

“…Traditional treatments include surgery, chemotherapy, and radiotherapy, often with fractionated wholebrain irradiation (fWBI). However, using radiotherapy, let alone fWBI, leads not only to inhibition of tumor growth, but also to deficits in cognitive function, such as loss of memory [107]. Interestingly, combination treatment with CSF‐1R and fWBI prolongs survival and rescues the fWBI‐associated cognitive function of mice with glioma, offering potent opportunities to improve both the survival and QoL of patients with gliomas [108].…”