Health-Related Quality of Life in Elderly Patients With Newly Diagnosed Glioblastoma Treated With Short-Course Radiation Therapy Plus Concomitant and Adjuvant Temozolomide

Abstract BACKGROUND In BIOMARK trial, patients with newly diagnosed glioblastoma were treated with standard chemoradiotherapy combined with first-line bevacizumab; a subset of patients continued bevacizumab beyond progression (BBP). Neurocognitive function (NCF), symptom burden, and health-related quality of life (HRQoL) were examined as secondary endpoints. PATIENTS AND METHODS In the primary protocol, newly diagnosed glioblastoma patients aged 20-75 received standard 6-week radiotherapy combined with temozolomide and bevacizumab followed by 4-week cycles of temozolomide plus bevacizumab, and then 2-3-week cycles of bevacizumab monotherapy. Upon recurrence, patients were subjected to the secondary protocol with 2-3-week cycles of bevacizumab monotherapy with or without other chemotherapeutic agents. NCF tests (Hopkins verbal learning test-revised, trail making test, and controlled oral word association), EORTC QLQ-C30/BN20, and MDASI-BT were completed by the patients. Time to deterioration (TTD) was defined as the time from randomization until a pre-specified change from baseline without further improvement or death. The Kaplan-Meier method and the log-rank test were used to assess TTD for each subscale of the above tests. RESULTS Overall, 94 patients were enrolled in the study. Analyses were based on the full analysis set cohort (N=90), excluding non-glioblastoma diagnosis by central review. The median overall survival (OS) and progression-free survival (PFS) were 25.0 and 14.9 months, respectively. Baseline HRQoL and symptom burden subscales (emotional functioning, symptom severity score, affective factor, and focal factor) were significantly associated with PFS. The median TTD was 8.7, 7.5, 8.1 months for global health status/QoL, symptom severity score, interference score, respectively. Among patients who experienced recurrence, disease progression was apparently preceded by deterioration in terms of symptom burden. CONCLUSIONS Detailed analysis of HRQoL and symptom burden may aid care of glioblastoma patients throughout the disease trajectory.

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Health-related quality of life and its predictors in patients receiving first-line treatment for newly diagnosed glioblastoma multiforme in EU5: A real-world study.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.29_suppl.157 ◽

2020 ◽

Vol 38 (29_suppl) ◽

pp. 157-157

Author(s):

Bryan Bennett ◽

Roelien Postema ◽

Jennifer P. Hall ◽

Abigail Bailey ◽

Lucy Massey ◽

...

Keyword(s):

Quality Of Life ◽

Glioblastoma Multiforme ◽

Functional Domain ◽

Newly Diagnosed ◽

Health Related Quality ◽

First Line ◽

Related Quality ◽

Health Related ◽

Newly Diagnosed Glioblastoma

157 Background: This study describes health-related quality of life (HRQoL) and its predictors including the role of O6-methylguanine DNA methyltransferase promoter (MGMT) testing in first-line (1L) patients (pts) with newly diagnosed glioblastoma multiforme (GBM). Methods: Real-world data were drawn from the GBM Disease-Specific Programme – a cross-sectional study administered to medical and neuro-oncologists who provided information on demographic/clinical status and treatment (tx) patterns for their next 4 consulting 1L GBM pts from May to July 2016 in EU5 countries. Pts voluntarily completed self-completion forms (PSCs), comprising the EORTC QLQ-C30, BN20, and EQ-5D-3L. Linear regressions were conducted using QLQ-C30 global health status (GHS), EQ-5D-3L utility, and EQ-5D visual analogue scale (VAS) scores as dependent variables. Demographic and clinical factors were included as independent variables. Statistically significant results with P<0.05 are presented. Results: 279 1L GBM pts completed a PSC, with a mean age 58.7 years old, 63% were male. 68% (n=189) were MGMT-tested with known results, of which 58% (n=110) were methylated and 42% (n=79) unmethylated. Mean GHS was 45.6 (SD=19.4), utility was 0.57 (SD=0.35), and VAS was 53.5 (SD=18.3). All functional domain scores of the QLQ-C30 were below reference values for general brain cancer population, with differences larger than published thresholds for clinical importance. Age >75 years and ECOG score of 2+ were associated with decreased HRQoL. Longer 1L tx duration, stable/responding disease, and receiving care in Germany, Italy, Spain, or UK (vs France) were associated with increased HRQoL. Results were similar for the subset of pts that was MGMT-tested; however, a greater Charlson index score and not receiving steroids (or RT) were associated with increased HRQoL. MGMT status did not appear to be an independent predictor of HRQoL. Conclusions: HRQoL in pts with GBM receiving 1L treatment is poor. Functional domain scores indicate clinically meaningful problems for these patients. Important predictors of HRQoL include age, performance status, time since tx initiation, country of care, comorbidities, and steroid use alongside RT. Results suggest there remains an unmet need in the tx management of GBM.

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