KEY TAKEAWAYS
- The study aimed to investigate the impact of age on post-radiation temozolomide extension in patients with newly diagnosed glioblastoma.
- Results showed that age did not affect glioblastoma survival with appropriate treatment.
The influence of age on the best approach for treating brain cancer like glioblastoma is uncertain. Recent research from GEINO14-01 and EX-TEM trials showed no advantage in prolonging post-radiation temozolomide for newly diagnosed glioblastoma.
Lucy Gately and the team conducted a study using a combined analysis of two randomized trials to explore age’s influence on the optimal management of glioblastoma.
The study employed relevant intergroup statistics to identify differences in tumor, treatment, and outcome characteristics based on age, categorizing elderly patients (EP) as those 65 and over. Survival was estimated using the Kaplan-Meier method.
Among the combined 205 patients, 57 (28%) were categorized as EP. Within this group, 95% exhibited ECOG scores of 0–1, and 65% underwent macroscopic resection, compared to 97% and 61% of younger patients (YP). There were numerically fewer MGMT-methylated tumors (56% vs. 63%, P= 0.4) and IDH-mutated tumors (4% vs. 13%, P= 0.1) in EP compared to YP.
Post-surgery, EP were more likely to receive short-course chemoradiation (17.5% vs. 6%, P = 0.017). Upon recurrence, EP tended towards receiving the 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 progression-free survival (PFS) was comparable between EP (9.3 months) and YP (8.5 months), with similar median overall survival (OS) at 20 months.
In this predominantly fit EP trial population, survival paralleled YP’s despite some receiving less aggressive therapy at diagnosis and recurrence. The findings suggest that advancing age may not detrimentally affect glioblastoma prognosis in patients deemed fit for treatment, potentially opening avenues for less aggressive therapeutic approaches in selected individuals without compromising outcomes.
Financial support for the studies was provided by the Victoria Comprehensive Cancer Centre (EX-TEM) and a grant from the Spanish Institute Carlos III (ISCIII: PI13/01751, Carmen Balana) (GEINO14-01).
Source: https://link.springer.com/article/10.1007/s11060-024-04668-5
Gately, L., Mesía, C., Sepúlveda, J., et al. (2024). “Exploring management and outcomes of elderly patients with glioblastoma using data from two randomised trials (GEINO1401/EX-TEM).” J Neurooncol (2024). https://doi.org/10.1007/s11060-024-04668-5.
