Objective:

Background:

GBM is the most common malignant primary intracranial tumor with a very poor prognosis. The median OS results are 11 months in the USA populace with SOC and 14.6 to 20.9 months in clinical trial cohorts.

Design/Methods:

Single-institution retrospective study of 528 eligible IDH wild-type GBM patients by WHO 2021 criteria from 2002 to 2024 was performed. Patients’ clinical information, treatments received, MRIs, adverse events, and molecular data were collected and analyzed. Survival results were calculated by the Kaplan-Meier method.

Results:

The extent of resection, GTR, NTR and STR, measured by post-operative MRI from the initial craniotomy were 36.1%, 17.2% and 36.3%, respectively. Among 202 patients with MGMT records, 37.13% were methylated while 62.87% were unmethylated. The Stupp regimen and Stupp regimen with TTF were administered in 81.25% and 10.79% patients, respectively. The OS for all patients is 19 months with 20, 40, 60 months OSs at 36.55%, 11.17%, 6.06%, respectively. For patients who received temozolomide/bevacizumab/irinotecan (TBI) (N = 47), TBI+TTF (N = 42), or the physician’s choice group (PCG) (N = 352), the OSs were 24, 20 and 13 months, respectively. Both TBI and TBI+TTF cohorts demonstrated statistically significant OS benefit when comparing with the PCG cohort (TBI: HR 0.51, 95% CI 0.33-0.78, p = 0.002) and (TBI+TTF: HR 0.54, 95% CI 0.33-0.90, p = 0.017). Reversible and manageable ≥ grade 3 adverse effects were observed including lymphopenia, (51.0% vs 41.2% vs 31.1%), hypertension (26.5% vs. 21.6% vs. 13.1%), and leukopenia (10.2% vs. 9.8% vs. 13.1%). 

Conclusions:

Timely determination of GBM at recurrence followed with combination of SOC interventions by a multidisciplinary team appears to improve survival in GBM patients.