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Journal Title: Exploring management and outcomes of elderly patients with glioblastoma using data from two randomised trials (GEINO1401/EX-TEM)
Authors: Gately, Lucy
Mesia, C.
Sepúlveda, J. M.
del Barco, S.
Pineda, E.
Gironés, R.
Fuster, J.
Dumas, M.
Gill, S.
Navarro, L. M.
Herrero, A.
Dowling, A.
de las Peñas, R.
Vaz, M. A.
Alfonso, M.
Lwin, Z.
Harrup, R.
Peralta, S.
Long, A.
Perez-Segura, P.
Ahern, E.
Garate, C. O.
Wong, M.
Campbell, R.
Cuff, K.
Jennens, R.
Gallego, O.
Underhill, C.
Martinez-Garcia, M.
Covela, M.
Cooper, A.
Brown, S.
Rosenthal, M.
Torres, J.
Gibbs, P.
Balana, C.
SWH Author: Collins, Ian
Keywords: Oncology
Issue Date: 17-Apr-2024
Publisher: Journal of Neuro-Oncology
Date Accessioned: 2024-04-22T03:41:50Z
Date Available: 2024-04-22T03:41:50Z
Accession Number: 10.1007
Source Volume: 167
Issue Number: 2
Database: Springer Link
DOI: 10.1007/s11060-024-04668-5
Abstract: Purpose The impact of age on optimal management of glioblastoma remains unclear. A recent combined analysis of two randomised trials, GEINO14-01 and EX-TEM, found no benefit from extending post-radiation temozolomide in newly diagnosed glioblastoma. Here, we explore the impact of age. Methods Relevant intergroup statistics were used to identify differences in tumour, treatment and outcome characteristics based on age with elderly patients (EP) defined as age 65 years and over. Survival was estimated using the Kaplan Meier method. Results Of the combined 205 patients, 57 (28%) were EP. Of these, 95% were ECOG 0–1 and 65% underwent macroscopic resection compared with 97% and 61% of younger patients (YP) respectively. There were numerically less MGMT-methylated (56% vs. 63%, p = 0.4) and IDH-mutated (4% vs. 13%, p = 0.1) tumours in EP vs. YP. Following surgery, EP were more likely to receive short course chemoradiation (17.5% vs. 6%, p = 0.017). At recurrence, EP tended to receive or best supportive care (28.3% vs. 15.4%, p = 0.09) or non-surgical options (96.2% vs. 84.6%, p = 0.06), but were less likely to receive bevacizumab (23.1% vs. 49.5%, p < 0.01). Median PFS was similar at 9.3months in EP and 8.5months in YP, with similar median OS at 20months. Conclusion In this trial population of predominantly fit EP, survival was similar to YP despite a proportion receiving less aggressive therapy at diagnosis and recurrence. Advancing age does not appear to be an adverse prognostic factor for glioblastoma when patients are fit for treatment, and a less aggressive approach in selected patients may not compromise outcomes.
Journal Title: Journal of Neuro-Oncology
ISSN: 0167-594X Print
1573-7373 Electronic
Type: Journal Article
Appears in Collections:SWH Staff Publications

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