377P - Comparison of current guidelines and real-world evidence data for the treatment of glioblastoma across Europe

Background

Glioblastoma (GBM) is the most frequent primary malignant brain tumor in adults. The standard of care in Europe is temozolomide (TMZ) ± lomustin and radiotherapy. In other countries (USA, Canada, and Switzerland) bevacizumab is approved for GBM, since it showed improved progression-free survival, however no overall survival increase was proven. Furthermore, no standard of care is established in recurrent or progressive cases due to the complex heterogeneity of the disease. Due to the limited treatment options in Europe and considering that bevacizumab is approved for GBM in other countries, treatment patterns based on real-world data will be analyzed to detect potential off-label use of bevacizumab in the UK and EU4 countries.

Methods

Anonymized patients-level data collected through a large web-based survey between January 2017 and December 2020 was used. The study reported patient case history information across all cancer types in EU4 (France, Germany, Italy, Spain) & UK. Treatment information on 3.657 glioblastoma drug treated patients was analyzed.

Results

The analysis of the treatment landscape of glioblastoma in Europe showed a share of 99% of (neo-)adjuvant and 89% of 1^st line patients treated with TMZ. However, when analyzing the 2^nd line only 17% of patients were treated with TMZ. On the other hand, bevacizumab treated patients represented a 0,1% in the (neo-)adjuvant setting, 6% in 1^st line which raised to 59% in the 2^nd line. More specifically a significant increase of bevacizumab treated patients from the 1^st to the 2^nd line was observed in Spain (1^st Line: 5%, 2^nd Line: 73%) and France (1^st Line: 12%, 2^nd Line: 90%). Furthermore, 73% of patients in Spain and 75% of patients in France changed therapy from TMZ to bevacizumab due to local/distant progression.

Conclusions

Conforming to the European guidelines, the majority of patients in (neo-)adjuvant and 1^st line setting are treated with TMZ. However, in France and Spain a high off-label use of bevacizumab has been identified in the 2^nd line. Most of those patients arise from an unsuccessful TMZ treatment due to progression of the disease.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

IQVIA Global Oncology, Central, East & South Europe.

Funding

IQVIA Global Oncology, Central, East & South Europe.

Disclosure

All authors have declared no conflicts of interest.