Meeting
2015 ASCO Annual Meeting
GLIOSTRY (GLIOblastoma regiSTRY) of the AINO (Italian Association of Neuro-Oncology): Analysis of factors influencing survival in glioblastoma patients receiving the nitrosourea fotemustine at first relapse following Stupp regimen.
Authors
Roberta Ruda
Department of Neuro-Oncology, University of Turin and City of Health and Science, Turin, Italy
Roberta Ruda , Giuseppe Lombardi , Silvia Scoccianti , Maria Grazia Fabrini , Matteo Santoni , Andrea Pace , Antonio Silvani , Alfredo Marinelli , Ivan Lolli , Mario Balducci , Mauro Arcicasa , Maurizio Salvati , Andrea Sponghini , Simona Vallarelli , Manuela Caroli , Francesca Imbesi , Domenico Bilancia , Marina Faedi , Stefano Cascinu , Riccardo Soffietti
Organizations
Department of Neuro-Oncology, University of Turin and City of Health and Science, Turin, Italy, Istituto Oncologico Veneto IRCCS, Padova, Italy, AOU Careggi, Firenze, Italy, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy, Medical Oncology, Polytechnic University of the Marche Region, Azienda Ospedaliero-Universitaria, Ospedali Riuniti Umberto I-GM Lancisi and G Salesi, Ancona, Italy, Neuro-Oncology Unit, Regina Elena National Cancer Institute, Rome, Italy, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy, Policlinico University Federico II, Napoli, Italy, Medical Oncology Unit, IRCCS Saverio de Bellis, Castellana Grotte, Italy, Department of Radiation Oncology, Catholic University of the Sacred Heart, Rome, Italy, C.R.O. Hospital, Aviano, Italy, Umberto I Hospital, Rome, Italy, Dipartimento Oncologico - AOU Maggiore della Carità, Novara, Italy, Azienda Ospedaliera Policlinico, Bari, Italy, Neurosurgery, University of Milano, Milano, Italy, Niguarda Hospital, Milano, Italy, AO Regionale San Carlo, Potenza, Italy, Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy, Department of Medical Oncology, Polytechnic University of the Marche Region, Ancona, Italy, University and S Giovanni Battista Hosp, Torino, TO, Italy
Research Funding
No funding sources reported
Background: patients with glioblastoma failing radiotherapy plus temozolomide are treated in Europe with nitrosourea-based regimens, but factors influencing survival are not entirely known.We investigated the factors influencing survival in a large cohort of Italian glioblastoma patients who received the nitrosourea fotemustine (FTM) at first relapse following the Stupp regimen. Methods: survival data and information on demographics, clinical, radiological, molecular and treatments factors were collected in 34 Italian Institutions. PFS and OS curves were constructed using the Kaplan-Meier method and both univariate and multivariate analysis were performed . Results: Since 2005, 921 (587 M 334 F, median age 56 yrs) patients were enrolled , and up to date 897 are evaluable. Median PFS following FTM was 103 days. Factors of prognostic significance in univariate analysis were: MGMT methylation (129 d methylated vs 90 d unmethylated tumors, p < 0.001) and association with bevacizumab (148 d the association vs 97 d FTM alone, p < 0.0001). Both MGMT status with an HR of 0.64 (0.52-0.79), p < 0,001, and association with bevacizumab with an HR of 0.71 (0.56-0.92), p < 0,008, remained significant after multivariate analysis. Median OS following FTM was 197 days. Factors of prognostic significance in univariate analysis were age (200 d < 65 yrs vs 182 d > 65 yrs, p = 0.0102), Karnofsky Performance Score (213 d KPS 90-100 vs 182 d KPS ≤ 80), extent of initial surgery (213 d gross total vs 184 d partial removal, p = 0.0022), MGMT status (246 d methylated vs 176 unmethylated tumors, p < 0.001) and association with bevaizumab (238 d association with bev vs 187 d FTM alone, p = 0.0297). MGMT status with HR of 0.60 (0.48-0.76), p < 0.001, and association with bevacizumab with HR of 0.73 (0.56-0.95), p = 0.022, remained significant after multivariate analysis. MGMT methylation was the strongest factor influencing OS from initial diagnosis. Conclusions: MGMT is a strong prognostic and predictive factor in GBM patients following FTM. The association of bevacizumab with FTM could be superior over FTM alone.
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Abstract Details
Session Type
Poster Session
Session Title
Central Nervous System Tumors
Track
Central Nervous System Tumors
Sub Track
Central Nervous System Tumors
Citation
J Clin Oncol 33, 2015 (suppl; abstr 2054)
DOI
10.1200/jco.2015.33.15_suppl.2054
Abstract #
2054
Poster Bd #
43
Abstract Disclosures
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