349P - Anaplastic astrocytoma (AA) and glioblastoma (GBM): a real-life experience in Padua Neuro-Oncology Center

Date 09 October 2016
Event ESMO 2016 Congress
Session Poster display
Topics Central Nervous System Malignancies
Presenter Giuseppe Lombardi
Citation Annals of Oncology (2016) 27 (6): 103-113. 10.1093/annonc/mdw367
Authors G. Lombardi1, A. Pambuku1, L. Bellu1, P. Fiduccia2, A. Della Puppa3, M. Gardiman4, F. Berti5, D. D'Avella6, V. Zagonel1
  • 1Department Of Clinical And Experimental Oncology, Medical Oncology 1, Veneto Institute of Oncology, 35100 - Padova/IT
  • 2Department Of Clinical And Experimental Oncology, Veneto Institute of Oncology, 35100 - Padova/IT
  • 3Neurosurgery Department, Azienda Ospedaliera Padova, 35100 - Padova/IT
  • 4Deaprtment Of Pathology, Azienda Ospedaliera Padova, 35100 - Padova/IT
  • 5Radiotherapy, Veneto Institute of Oncology, 35100 - Padova/IT
  • 6Neurosurgery Department, University of Padova, 35100 - Padova/IT

Abstract

Background

Various prospective clinical trials on high-grade gliomas were performed in the last years but patient (PTS) characteristics and outcome may be different in real clinical practice. We performed a retrospective analysis to evaluate the real-life experience in Padua Neuro-Oncology center.

Methods

Retrospectively, we reviewed the medical records of PTS admitted to our observation from June 2010 to June 2015 with a diagnosis of AA or GBM. We analyzed clinical outcome with prognostic factors

Results

We analyzed 592 PTS with a diagnosis of CNS primary tumor. Among these, we enrolled 395 PTS: 33 (8.4%) with a histological diagnosis of AA, 293 (74%) with a histological diagnosis of GBM and 69 (17.4%) with a radiological diagnosis of GBM. At diagnosis, median age was 63.2 (range 24-88), 61.8% were male; 80% of PTS had an ECOG PS 0-2. Among PTS who underwent surgery, 48% had a radical surgery; 279 PTS (70.6%) performed RT in association to chemotherapy. 17% of PTS performed a second surgery at relapse and 45% a second-line treatment. MGMT was analyzed in all PTS who underwent surgery: it was methylated in 38.7% of PTS, IDH1 was mutated in 6%. GBM PTS with ECOG PS 0-2 and >2 had a median OS of 21.1 and 7.2 ms, respectively. GBM PTS with met and unmet MGMT had a mOS of 22.7 and 13.7 ms (p = 0.005). AA PTS with met and unmet MGMT had a mOS of 29.5 and 16.6 ms (p = 0.03). Considering all high-grade gliomas, PTS with met MGMT + mutIDH1 reported a mOS of 23.1ms, PTS with metMGMT + wtIDH1 had a mOS of 20.9 ms and PTS with unmetMGMT + wtIDH1 showed a mOS of 12.6ms (p 

Conclusions

In our real-life experience most PTS underwent surgery, performed a radiation therapy in association to chemotherapy and nearly half of PTS performed a second-line chemotherapy, although a subset of PTS had a poor performance status. However, we reported a good clinical outcome demonstrating the importance of molecular characterization in these PTS. Type of surgery, ECOG PS, MGMT methylation and lines of chemotherapy were independent prognostic factors

Clinical trial identification

Legal entity responsible for the study

IOV

Funding

None

Disclosure

All authors have declared no conflicts of interest.