434P - Outcome of high grade glioma patients: A single institution experience

Background

High Grade Glioma include all grade III/IV primary brain tumors of Astrocytic, oligodendroglial and mixed cellular lineage and are associated with poor prognosis. The standard of care for high grade glioma is concomitant chemoradiation and Temozolomide with median survival of 12-15 months in glioblastoma and 2-5 years with newly diagnosed anaplastic gliomas. Prognosis is poor with the median survival of 3-9 months at first recurrence which drops to few weeks for more than 90% of the patients at second or subsequent recurrence. Our main objective is to determine Progression free survival after first and second line of treatment and Overall survival in patients with high grade glioma at a tertiary care center in Pakistan.

Methods

Patients with newly diagnosed High Grade Glioma after surgical resection and biopsy are assigned to recieved standard of care treatment i.e concomitant chemoradiation and temozolomide and was followed and on recurrence received Bevacizumab 10mg/kg with or without Irinotecan 125mg/m2 every 3 weekly.

Results

From 2016 to 2021, total of 117 newly diagnosed patients with High grade Glioma presented at Oncology department of Aga Khan University Hospital were included. Majority were male 80 (68.38) and the median (IQR) age was 51 (41-60%). Among high grade glioma majority have GBM (66%). 64% underwent subtotal resection, 23% and 11% had Gross total resection and biopsy respectively. Most of the patients 87 (74.3%) recieved concomitant chemoradiation followed by Temozolomide until disease progression as a systemic treatment. Moreover 75 (64.10%) patients recieved Irinotecan and Bevacizumab as a second line treatment. The median (IQR) progression free survival after primary treatment was 18 (11-29) months and 14 (12-24) months after second line treatment. Two third of the patients were dead at the end of follow up 74 (63.25%). The median (IQR) overall survival was 37 (26-46) months.

Conclusions

Our data reveal that combination of Bevacizumab and Irinotecan improves the outcome in high grade glioma when compared to historical results. Survival rates were high as reported in international studies. Should be used as standard of care in recurrent high grade glioma.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.