Prognosis of GBM pts is still poor with a median survival of 15 months; however a small fraction survives more than 30 months, defined in our study as long term survivors (LTS-30).
We performed a multicenter retrospective and prospective study of newly GBM pts treated with the Stupp Regimen. In the present sub-study we analyze clinical characteristics and molecular factors in LTS-30 compared with pts surviving less than 30 months, including the MGMT and the IDH1 status.
From 2005 to 2014, 432 GBM pts treated with the Stupp Regimen were included with a median progression free survival (mPFS) of 8 months (m) and a median overall survival (mOS) of 14 months, of which 66 (15.3%) were LTS-30, with a mPFS of 24 m and a mOS of 41 m. In this population median karnofsky (KPS) was better (90% vs 80%) with less patients with KPS inferior to 70% (1.9% vs 13.9%; p = 0.006), and median age was also lower (58 vs 62 years) with more pts ≤50 years (34.8% vs 18.3%; p = 0.003). Median OS in patients with IDH1 mutation was 30 m vs 16 m (p = 0.005). Methylated MGMT and mutated IDH1 were significantly more frequent in LTS-30, 75% vs 40.8% (p
Identifying potential LTS in GBM might be a meaningful endpoint in order to establish the best therapeutic strategy. In our study, methylation status of MGMT is the only independent prognostic factor of LTS-30 in GBM pts treated with Stupp regimen. As expected, patients with LTS-30 are younger with better KPS and with more frequent IDH1 mutation.
Clinical trial identification
Marato Project: 665/C/2013.
Legal entity responsible for the study
IGTP, IDIBELL, Fundacio Parc Salut Mar, Fundacio Clinic
Marato Project: 665/C/2013
All authors have declared no conflicts of interest.