139O - Systematic review and individual patient data analysis of uncommon GBM variants: An analysis of 196 cases

Date 17 December 2016
Event ESMO Asia 2016 Congress
Session CNS tumours
Topics Central Nervous System Malignancies
Presenter Supriya Mallick
Citation Annals of Oncology (2016) 27 (suppl_9): ix42-ix45. 10.1093/annonc/mdw578
Authors S. Mallick, R. Benson, B. Venkatesulu, G.K. Rath
  • Radiotherapy, All India Institute of Medical Sciences, 110029 - Delhi/IN

Abstract

Background

Different variant of GBM has been reported viz. Epithelioid GBM (GBM-E), Rhabdoid GBM (GBM-R), Small cell GBM (GBM-SC), Giant cell GBM (GBM-GC), GBM with neuro ectodermal differentiation (GBM-PNET) with unknown behavior.

Methods

We conducted a systematic review and individual patient data analysis of rare GBM variants. We searched PubMed, google search, and Cochrane library for eligible studies till July 1st 2016 published in English language and collected data regarding age, sex, subtype, and treatment received, DFS, OS. STATA 12 software was used for all statistical analysis.

Results

We retrieved data of 196 patients with rarer GBM subtypes. Among these GBM-GC is commonest (51%), followed by GBM-R (19%), GBM-PNET (13%), GBM-SC (9%) and GBM-E (8%). Median age for these was 38, 40, 43.5, 69.5 and 18 years. Male: female ratio was 2:1 for GBM-E, 1:3 for GBM-SC. Maximal safe resection followed by adjuvant radiation was advocated for most of the patients. However, 6 GBM-PNET, 3 each of GBM-E, GBM-SC received Craniospinal radiation. Out of 76 patients, 50 received Temozolomide as adjuvant therapy. Median PFS and OS for the entire cohort were 8 and 16.5 months. In univariate analysis patient with a GTR had significantly better survival compared to those with a STR [23 vs. 13 months (p-0.01)]. Median OS for GBM PNET 32 months; GBM-GC 18.3 months; GBM-SC 11 months; GBM-R 12 months; and GBM-E 7.7 months (p = 0.002). 31.3%, 37.8% patients with GBM-E, GBM-R had CSF dissemination.

Conclusions

Overall cohort of rarer GBM variant has equivalent survival compared to GBM not otherwise specified. However, epithelioid and Rhabdoid GBM has worst survival and one third shows CSF dissemination.

Clinical trial indentification

NA

Legal entity responsible for the study

Supriya Mallick

Funding

N/A

Disclosure

All authors have declared no conflicts of interest.