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 treatment | Percentage of responders | |
---|---|---|
Glioblastoma, age 70-80 (PS 0-1, minor comorbility) | Perry Stupp | 46.2 % 38.5 % |
Glioblastoma, age >80 (PS 0-1, mior comorbility | Perry | 46.2 % |
Glioblastoma, age 65-70 (PS 0-1, minor comorbility) | Stupp | 80.8 % |
Glioblastoma, no MGMT methylation 70-80 >80 65-70 | Stupp Perry Stupp | 50 % 34.6 % 68.5 % |
Glioblastoma >65, PS > 2 | Stupp | 36.8 % |
Anaplastic astrocytoma 70-80 yo | Perry | 30.8 % |
Anaplastic astrocytoma >80 | Perry | 34.6 % |
Anaplastic astrocytoma 65-70 | Stupp | 53.8 % |
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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