P02.02 Treatment and Outcomes in Glioblastoma Multiforme: A multi-country chart review study

Abstract Background: There is an existing unmet need in glioblastoma multiforme (GBM) due lack of effective treatment options. To understand the treatment landscape as newer agents are in development, it was the objective of this study to gain a better understanding of the current treatment of second line (2L) GBM therapy with related outcomes in a “real-world” setting in Canada, France and Germany. Methods: A retrospective, chart-review study was conducted in each country; 72 oncologists were recruited to contribute patients ≥18 years of age, newly diagnosed with GBM between January 1, 2013 - June 30, 2015 with a minimum of 12 months follow-up or until death. Excluded were those treated with investigational agents. Patients were followed through August 2016. Enrollment was in 2 cohorts, Cohort 1 comprising a random selection of 337 patients irrespective of line of the therapy (LOT). Cohort 2 included 136 patients who received more than one LOT for a total N = 473 (146 each in France and Germany, and 181 in Canada). Demographics and treatment data were analyzed descriptively. Survival was determined using Kaplan-Meier analysis censoring for date of chart abstraction in surviving patients. Results: Patients were 61% male with mean (SD) age of 61.4 (12.0) years at initial diagnosis. Overall, most patients (92%) were treated 1L with temozolomide (TMZ) monotherap and 88% received radiation. In the 337 patient random sample, 97 (29%) received 2L treatment. A total of 233 patients in both cohorts were analyzed for 2L treatment and outcomes. Of all 2L-treated patients the majority were Eastern Cooperative Oncology Group (ECOG) performance grade 1 (38%) or 2 (49%) at the time of 2L start. In 2L, 27% were retreated with TMZ monotherapy, 7% received TMZ in combination with other agents, 40% received bevacizumab either as monotherapy 22%, or combination therapy (18%). In all patients receiving a 2L therapy, complete response following 2L was achieved by 5%, 23% partial response and 29%, stable disease. Median overall survival from start of 2L was 7.5 months (95% CI 6.5 – 8.5) in all patients, (7.0 [95% CI 6–8.1] in France; 6.0 [95% CI 4.5–7.4] in Germany; 10.5 [95% CI 8.6–12.5] in Canada). Conclusions: Most GBM patients received TMZ during 1L and bevacizumab monotherapy or combination therapy during 2L treatment with some regional differences. Survival following initiation of 2L treatment was poor. Prognosis remains grim under current treatment paradigms.