Despite improvements in median and short-term survival rates for patients with glioblastoma, the most common brain tumor in adults, the percentage of patients who reach five-year survival remains low, according to new Mayo Clinic research.
A study will be published next month of Mayo Clinic procedures finds that little has changed in terms of five-year survival -; only 5.5% of patients live for five years after diagnosis -; and requires more aggressive treatments to be considered for all patients with glioblastoma.
Gliomas represent about 75% of primitive malignant brain tumors, according to previous studies, and glioblastoma, the grade 4 glioma, is among the most aggressive forms of cancer. The retrospective analysis of 48,652 cases in the National Cancer Database from January 2004 to December 2009 found that 2,249 patients survived at least five years after diagnosis. Among those who achieved five-year survival, the median duration of survival was 88 months. Patients who did not survive five years had a median survival of only seven months.
The introduction of chemotherapy in the treatment of glioblastoma has been revolutionary, although this research suggests that chemotherapy serves more as a temporary measure against disease recurrence and death. Considerable work is needed to give hope to patients with glioblastoma ".
Daniel Trifiletti, M.D., Mayo Clinic, oncologist radiologist and senior author of the study
The study involved researchers in oncology, radiology and biomedical statistics from the Mayo Clinic's Florida and Minnesota campuses and from East Tennessee State University.
According to the study, the factors associated with five-year survival included age, race and sex. Those who achieved five-year survival were relatively young, female and not white adults. Other factors generally included good health, a higher average income, tumors that were on the left side of the brain or outside the brain stem, and treatment with radiation therapy. Contrary to previous studies, tumor size did not appear to significantly influence the chances of long-term survival.
The results suggest that more aggressive treatments that focus on long-term survival will be needed. "Although it is not clear how this can be achieved, it will probably require new and radical approaches to the treatment of the disease," says Dr. Trifiletti. The study recommends that almost all patients should be offered for enrollment in a clinical trial.
Dr. Trifiletti says that there are several ongoing studies that promise new surgical interventions, radiotherapy techniques and drug therapies. "For me, the most exciting area is cell therapy," he says. "In my laboratory I am evaluating the possibility of using targeted cell therapy as an agent capable of synchronizing with existing therapies, including radiation."
Dr. Trifiletti reveals that he has received research grants from NovoCure, and Paul D. Brown, M.D., an oncologist and radiation author of the Mayo Clinic, is part of IQVIA Biotech's data monitoring and security panel. The other authors do not report competing interests.
. [tagToTranslate] Glioblastoma