Prognosis of glioblastoma patients improves significantly over time interrogating historical controls
Alice Thomas-Joulié, Suzanne Tran, L. El Houari, Antoine Seyve, Franck Bielle, Cristina Birzu, Fernando Lozano-Sanchez, Karima Mokhtari, Marine Giry, Y. Marie, Florence Laigle–Donadey, Caroline Dehais, Caroline Houillier, Dimitri Psimaras, Agustí Alentorn, Alice Laurenge, Mehdi Touat, Marc Sanson, Khê Hoang‐Xuan, Aurélie Kas, Laura Rozenblum, M.‐O. Habert, Lucia Nichelli, Delphine Leclercq, Damien Galanaud, J. Jacob, Carine Karachi, L. Capelle, Alain Carpentier, Bertrand Mathon, Lisa Belin, Ahmed Idbaïh
Abstract
BACKGROUND: Glioblastoma (GBM) is the most common devastating primary brain cancer in adults. In our clinical practice, median overall survival (mOS) of GBM patients seems increasing over time. METHODS: To address this observation, we have retrospectively analyzed the prognosis of 722 newly diagnosed GBM patients, aged below 70, in good clinical conditions (i.e. Karnofsky Performance Status -KPS- above 70%) and treated in our department according to the standard of care (SOC) between 2005 and 2018. Patients were divided into two groups according to the year of diagnosis (group 1: from 2005 to 2012; group 2: from 2013 to 2018). RESULTS: Characteristics of patients and tumors of both groups were very similar regarding confounding factors (age, KPS, MGMT promoter methylation status and treatments). Follow-up time was fixed at 24 months to ensure comparable survival times between both groups. Group 1 patients had a mOS of 19 months ([17.3-21.3]) while mOS of group 2 patients was not reached. The recent period of diagnosis was significantly associated with a longer mOS in univariate analysis (HR=0.64, 95% CI [0.51 - 0.81]), p < 0.001). Multivariate Cox analysis showed that the period of diagnosis remained significantly prognostic after adjustment on confounding factors (adjusted Hazard Ratio (aHR) 0.49, 95% CI [0.36-0.67], p < 0.001). CONCLUSION: This increase of mOS over time in newly diagnosed GBM patients could be explained by better management of potentially associated non-neurological diseases, optimization of validated SOC, better management of treatments side effects, supportive care and participation in clinical trials.