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Poster Display session 1

3088 - Spanish Survey of treatment recommendations for elderley patients with glioblastoma

Date

28 Sep 2019

Session

Poster Display session 1

Topics

Tumour Site

Central Nervous System Malignancies

Presenters

María Ángeles Vaz Salgado

Citation

Annals of Oncology (2019) 30 (suppl_5): v143-v158. 10.1093/annonc/mdz243

Authors

M.Á. Vaz Salgado1, Á. Rodríguez Sánchez2, I. Fernandez Perez3, T. Quintanar4, M. Navarro Martin5, M. Vieito Villar6, J.M. Cano7, S. Gonzalez8, S. Ros9, A. Herrero Ibañez10, M.A. Ivars11, M. Lloret12, M. Alonso13, I. Moya14, R. Luque15, M. Benavides16, M. Gutiérrez Toribio17, J. García - Gómez18, J. Esteban Villarrubia19, J. Torres Jimenez1

Author affiliations

  • 1 Dept. Oncologia Medica, Hospital Universitario Ramon y Cajal, 28031 - Madrid/ES
  • 2 Oncology, Complejo Asistencial Universitario de León, 24071 - Leon/ES
  • 3 Dept. Oncologia Medica, CHUVI - Complejo Hospitalario Universitario de Vigo, 36204 - Vigo/ES
  • 4 Dept. Oncologia Medica, Hospital General Universitario de Elche, Elche/ES
  • 5 Dept. Oncologia Medica, IBSAL - Instituto de Investigación Biomédica de Salamanca, 37007 - Salamanca/ES
  • 6 Medical Oncology Dept., Vall d'Hebron University Hospital - Vall d'Hebron Institute of Oncology VHIO, 08035 - Barcelona/ES
  • 7 Medical Oncology, Hospital General Ciudad Real, 13005 - Ciudad Real/ES
  • 8 Oncology, Hospital Mutua de Terrassa, Terrassa/ES
  • 9 Oncology, Hospital Universitario Virgen de la Arrixaca, Murcia/ES
  • 10 Oncology, Hospital Miguel Servet, 50009 - Zaragoza/ES
  • 11 Oncology, Hospital Universitario Morales Meseguer, 30008 - Murcia/ES
  • 12 Oncology, Hospital Universitario Insular de Gran Canaria, Las Palmas/ES
  • 13 Oncology, Hospital Universitario Virgen del Rocío, Sevilla/ES
  • 14 Oncology, H. General Catalunya Instituto Oncológico Dr Rosell, Barcelona/ES
  • 15 Service Of Medical Oncology, Hospital Universitario Virgen de las Nieves, 18014 - Granada/ES
  • 16 Oncology, Universitario Regional Virgen de la Victoria, Malaga/ES
  • 17 Oncology, Hospital Universitario de Araba, Alava/ES
  • 18 Oncology, Complejo Hospitalario Universitario de Orense, Orense/ES
  • 19 Medical Oncology Dept., Hospital Universitario Ramon y Cajal, 28031 - Madrid/ES

Resources

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Abstract 3088

Background

Glioblastoma (GB) is the most common malignant CNS tumor. Incidence ingreases with age, peaking between 69 and 84 yers, and half of patients diagnosed have > 65 years. The question about how to treat these patients remains object of controversy. The purpose of this survey was to know the treatment recommendations for BG in academic Spanish hospitals.

Methods

In 2018, surveys were e-mailed to all members of GEINO (Spanish Group for Neurooncology Reseach). The survey contained specific questions on the routine clinical practice regarding treatment recommendations for elderly patients with GB and anaplastic astrocytoma in different clinical situations: depending on ECOG, morbility, MGMT promoter methylation, age intervals (between 65-70 y, 70-80 y, >80 y). Response options were: a) Stupp regimen, b) Perry regimen, c) Radiation or TMZ depending on MGMT status and d) supportive care. Participants were also asked if they used MGMT status to select patients for Stupp or Perry regimen.

Results

Twenty-six neuro-oncoligist from twenty-six hospitals completed the survey. Mean of hospital beds of the institutions were 833.19 (range 150-1500). Mean of hospital veds of the instituions were 833,19 (range 150-1500). Median number of new cases treated per year were 31 (range 8-80). In patients with ECOG 0-1 and between 65 and 70 years old, 80.8 % of participants would recommend treatment with Stupp regiment. For patients with ECOG 0-1 and between 70-80; 46.2 % recommenden Perry regimen in methylated (M) and unmethylated (UM) patients; 38.5 % recommended Stupp regimen in both. For with ECOG 0-1 and > 80 % yo, 46,2 % recommend Perry regimen in both M and UM; 3.8 % Stupp regimen; 15,4 % radiation or TMZ according to MGMT status. In patients with anaplastic astrocytoma aged 70-80 y, 46,2 % would recommend Perry regimen and 42,3 % Stupp regimen.Table: 411P

Most recommend treatmentPercentage of responders
Glioblastoma, age 70-80 (PS 0-1, minor comorbility)Perry Stupp46.2 % 38.5 %
Glioblastoma, age >80 (PS 0-1, mior comorbilityPerry46.2 %
Glioblastoma, age 65-70 (PS 0-1, minor comorbility)Stupp80.8 %
Glioblastoma, no MGMT methylation 70-80 >80 65-70Stupp Perry Stupp50 % 34.6 % 68.5 %
Glioblastoma >65, PS > 2Stupp36.8 %
Anaplastic astrocytoma 70-80 yoPerry30.8 %
Anaplastic astrocytoma >80Perry34.6 %
Anaplastic astrocytoma 65-70Stupp53.8 %

Conclusions

Our research demonstrates there is no uniform approach to the management of elderly patient with glioblastoma among academic neuro-oncologist.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

GEINO (Grupo Español de Investigación en Neurooncología).

Funding

Has not received any funding.

Disclosure

M. Vaz Salgado: Advisory / Consultancy, Travel / Accommodation / Expenses: Pharmamar; Advisory / Consultancy: Lilly, Eisai y Celgene; Research grant / Funding (self): Pfizer. M. Vieito Villar: Travel / Accommodation / Expenses: Roche. R. Luque: Honoraria (self), Travel / Accommodation / Expenses: Janssen-Cilag; Honoraria (self), Travel / Accommodation / Expenses: Sanofi Aventis; Honoraria (self), Travel / Accommodation / Expenses: Astellas Medivation; Honoraria (self), Travel / Accommodation / Expenses: Roche; Honoraria (self), Travel / Accommodation / Expenses: Novartis; Honoraria (self), Travel / Accommodation / Expenses: Pfizer; Honoraria (self), Travel / Accommodation / Expenses: Bristol Mayers Squibb; Honoraria (self), Travel / Accommodation / Expenses: EUSA Pharma. All other authors have declared no conflicts of interest.

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