458P - Patterns of care and clinical outcomes of patients with glioblastoma in the United States from 2005-2020: A real-world analysis

Background

Survival for glioblastoma (GBM) remains low, with disparities affecting outcomes. Standard of care (SoC) includes surgery and adjuvant chemoradiation. This study explores demographics, treatment patterns, and outcomes of GBM patients (pts) in the United States (US).

Methods

We queried the US National Cancer Database for GBM pts diagnosed in 2005-2020 according to ESMO Guidance for Reporting Oncology Real-World (GROW). Trends were analyzed with descriptive statistics and X²-test between time periods: 2005-08, 2009-12, 2013-16, and 2017-20. Predictors of SoC receipt were analyzed with multivariate logistic regression. Median overall survival (mOS) estimated using Kaplan-Meier and Cox regression models. Adjustment made using demographic, socioeconomic, and clinical factors. Outcomes reported as [Odds Ratio (OR)/Hazard Ratio (HR) 95% Confidence Interval (CI)] per STROBE guidelines.

Results

Of 104,697 GBM pts, 42.7% were female. 91.2% White, 5.7% Black, and 2.0% were Asian. 5.3% were Hispanic. Median age was 65 years (Interquartile Range: 57-73). Percentage of pts ≥ 65 years increased from 48.8% in 2005-08 to 54.0% in 2017-20. 56.5% of pts received SoC. SoC usage increased over time: 2009-12 (OR 1.26, CI 1.21-1.31, P<0.001) vs 2013-16 (OR 1.36, CI 1.31-1.42, P<0.001) vs 2017-20 (1.51, CI 1.45-1.57 P<0.001). Females (OR 0.91, CI 0.89-0.93 P<0.001), Black (OR 0.81, CI 0.77-0.86 P<0.001), and Hispanics (OR 0.91, CI 0.86-0.97, P=0.004) were less likely to receive SoC than males, White, and non-Hispanics. Privately insured were more likely to receive SoC than Medicare (OR 0.83, CI 0.80-0.87, P<0.001), Medicaid (OR 0.67, CI 0.64-0.71, P<0.001), and uninsured pts (OR 0.60, CI 0.55-0.64, P<0.001). SoC recipients had mOS of 14.6 months (CI 14.5-14.8) vs 4.8 (CI 4.7-4.9) for non-recipients (P<0.001). Compared to 2005-08, survival improved over time: 2017-20 (HR 0.84, CI 0.82-0.85, P<0.001) vs 2013-16 (HR 0.88, CI 0.86-0.89, P<0.001) vs 2009-12 (HR: 0.93, CI 0.91-0.94, P<0.001).

Conclusions

Receipt of SoC has risen with significant increase in survival. However, female, Black and Hispanic pts were less likely to receive SoC. Targeted efforts are warranted to mitigate disparities.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

M. Ahluwalia: Financial Interests, Personal, Research Grant: Seagan; Financial Interests, Personal, Advisory Role: Bayer, Kiyatec, Insightec, GSK, Xoft, Nuvation, SDP Oncology, Apollomics, Prelude, Janssen, Voyager Therapeutics, Viewray, Caris Lifesciences, Pyramid Biosciences, Varian Medical Systems, Cairn Therapeutics, Anheart Therapeutics, Theraguix, Menarini Ricerche, Sumitomo Pharma Oncology, Autem therapeutics, GT Medical Technologies, Allovir, Equillium Bio, VBI Vaccines; Financial Interests, Personal, Advisory Board: Modifi biosciences, Bugworks; Financial Interests, Personal, Stocks/Shares: Mimivax, Cytodyn, MedInnovate Advisors LLC, Trisalus Lifesciences. All other authors have declared no conflicts of interest.