Clinical and molecular features associated with long-term survival of elderly patients with glioblastoma.
Central Nervous System Tumors
Central Nervous System Tumors
2017 ASCO Annual Meeting
Poster Board Number:
Poster Discussion Session (Board #255)
J Clin Oncol 35, 2017 (suppl; abstr 2013)
Author(s): Michael Weller, Martin Sill, Bettina Hentschel, Joerg Felsberg, David T. W. Jones, Dorothee Gramatzki, Kerstin Kaulich, Caroline Happold, Joerg Tonn, Ulrich Herrlinger, Gabriele Schackert, Manfred Westphal, David Capper, Rajiv Kumar, Kari Hemminki, Torsten Pietsch, Markus Loeffler, Stefan M. Pfister, Andreas von Deimling, Guido Reifenberger, German Glioma Network; Laboratory of Molecular Neuro-Oncology, Department of Neurology, and Neuroscience Center Zurich, University Hospital and University of Zurich, Zurich, Switzerland; Division of Biostatistics, German Cancer Research Center (DKFZ), Heidelberg, Germany; Institute for Medical Informatics, Statistics and Epidemology, Leipzig University, Leipzig, Germany; Department of Neuropathology, Heinrich-Heine University, Düsseldorf, Germany; Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), and Department of Pediatric Oncology, Hematology and Immunology, University Hospital Heidelberg, and German Cancer Consortium (DKTK), Heidelberg, Germany; Department of Neurosurgery, Ludwig-Maximilians-University Munich, Munich, Germany; Department of Neurology, University of Bonn Medical Center, Bonn, Germany; Department of Neurosurgery, Technical University Dresden, Dresden, Germany; Department of Neurosurgery, University of Hamburg, Hamburg, Germany; Department of Neuropathology, Institute of Pathology, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany; Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany; Department of Neuropathology, University of Bonn Medical Center, Bonn, Germany; Department of Neuropathology, Heinrich-Heine University, Heidelberg, Germany
Background: Glioblastomas in elderly patients are associated with particularly poor outcome, with only few patients demonstrating long-term survival (LTS). Methods: To better characterize clinical and molecular correlates of LTS in elderly glioblastoma patients, we searched the German Glioma Network (GGN) database for patients aged 71 years or more with histological confirmation of glioblastoma and survival of at least two years after diagnosis. Results: Of 2071 glioblastoma patients enrolled in the GGN from 2004-2012, 425 patients were aged 71 years or more; of these, 27 patients (6.4%) survived for 2 years or more (median survival: 37.1 months, 95% confidence interval: 30.0-44.2 months). A comparison of these 27 patients with the 398 patients who survived shorter than 2 years (median survival: 6.2, 95% confidence interval: 5.2-7.2 months) revealed more intensive up-front treatment and a trend towards higher initial Karnofsky performance score as distinguishing clinical factors. Molecular analyses additionally showed more frequent O6-methylguanine-DNA methyltransferase (MGMT) promoter methylation in the LTS patients. Isocitrate dehydrogenase (IDH) mutation was restricted to single patients and the frequency of telomerase reverse transcriptase (TERT) promoter mutation did not differ between groups. Genome-wide DNA copy number and methylation profiling using 450k microarray analysis performed for 16 LTS patients and 40 control patients revealed limited differential DNA methylation and no specific copy number profiles linked to LTS. Conclusions: Collectively, our findings confirm that LTS is rare in elderly patients with glioblastoma and that clinical and tumor-associated molecular factors linked to LTS resemble those in standard age patients, except for less common IDH mutation.
Categories: Brain Tumor