Prognostic significance of therapy-induced myelosuppression in newly diagnosed glioblastoma.

Authors

null

Michael Weller

Department of Neurology, University Hospital and University of Zurich, Zurich, Switzerland

Michael Weller , Felix Boakye Oppong , Maureen Vanlancker , Roger Stupp , Louis B. Nabors , Olivier L. Chinot , Wolfgang Wick , Matthias Preusser , Thierry Gorlia , Emilie Le Rhun

Organizations

Department of Neurology, University Hospital and University of Zurich, Zurich, Switzerland, EORTC Headquarters, Brussels, Belgium, EORTC, Brussels, Belgium, Northwestern University, Chicago, University of Alabama at Birmingham, Birmingham, AL, Aix-Marseille Univ, APHM, CNRS, INP, Inst Neurophysiopathol, CHU Timone, Service de Neurooncologie, Marseille, France, National Center for Tumor Diseases (NCT), UKHD and German Cancer Research Center (DKFZ), Heidelberg, Germany, Department of Medicine I, Division of Oncology, Medical University of Vienna, Vienna, Austria, Lille University Hospital, Lille, France

Research Funding

Other

Background: Myelosuppression is the major toxicity encountered during temozolomide chemoradiotherapy for newly diagnosed glioblastoma. Methods: We assessed the association of myelosuppression (neutropenia, thrombocytopenia, anemia, lymphopenia) during temozolomide chemoradiotherapy alone or in combination with experimental agents with progression-free survival (PFS) or overall survival (OS) in 2073 patients with newly diagnosed glioblastoma enrolled into five clinical trials: CENTRIC, CORE, EORTC 26082, AVAglio, and EORTC 26981. A landmark analysis approached was used. For each primary association analysis, a significance level of 1.7% was used. Results: Lower neutrophil counts at baseline were associated with better PFS (p = 0.011) and OS (p < 0.001), independently of steroid intake. Females experienced uniformly more myelotoxicity than males. Lymphopenia during concomitant chemoradiotherapy was associated with OS (p = 0.009): low-grade (1-2) lymphopenia might be associated with superior OS (HR 0.78, 98.3% CI 0.58-1.06) whereas high-grade (3-4) lymphopenia might be associated with inferior OS (HR 1.08, 98.3% CI 0.75-1.54). There were no associations of altered hematological parameters during concomitant chemoradiotherapy with PFS. During maintenance chemoradiotherapy, no significant association was found between any parameter of myelosuppression and PFS or OS, although exploratory analysis at 5% significance level indicated that either mild-to-moderate (HR 0.76, 95% CI 0.62-0.93) or high-grade lymphopenia (HR 0.65, 95% CI 0.46-0.92) were associated with superior OS (p = 0.013), but not PFS. Conclusions: The association of higher neutrophil counts at baseline with inferior PFS and OS requires further prospective evaluation. The link of therapy-induced lymphopenia to better outcome may guide the design for immunotherapy trials in newly diagnosed glioblastoma.

Disclaimer

This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org

Abstract Details

Meeting

2022 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Central Nervous System Tumors

Track

Central Nervous System Tumors

Sub Track

Primary CNS Tumors–Glioma

Citation

J Clin Oncol 40, 2022 (suppl 16; abstr 2055)

DOI

10.1200/JCO.2022.40.16_suppl.2055

Abstract #

2055

Poster Bd #

393

Abstract Disclosures