Is Long-Term Survival in Glioblastoma Possible? Updated Results of the EORTC/NCIC Phase III Randomized Trial on Radiotherapy (RT) and Concomitant and Adjuvant Temozolomide (TMZ) versus RT Alone
Scientific Session: Is Long-Term Survival in Glioblastoma Possible? Updated Results of the EORTC/NCIC Phase III Randomized Trial on Radiotherapy (RT) and Concomitant and Adjuvant Temozolomide (TMZ) versus RT Alone
Stupp et al. (New England Journal 2005) reported improvement in 2-year survival in patients with GBM treated with concurrent radiation and temozolomide followed by adjuvant temozolomide, compared to patients treated with radiation alone after surgery. This presentation is an update of that study, with data up to October 1, 2007.
The study enrolled 573 patients and the median * time of follow up is 16 months. Patients were randomized to receive either post-operative radiation alone or post-operative radiation with concurrent temozolomide (given at the same time), followed by temzolomide for 6 months. The purpose of the study was to look for an improvement in survival.
The combination therapy resulted in improved survival for most groups of patients (the study broke them down into groups based on age, health status, and performance status). The exception was that no significant advantage was seen for patients over age 50 with poor mental status prior to treatment. For all groups combined, overall survival for radiation alone versus combination therapy was:
- 2 year OS: 11% versus 27%
- 3 year OS: 4% versus 16%
- 4 year OS: 3% versus 12%
This study shows the benefit of temzolomide, which is now considered standard therapy for GBM. Studies are currently looking at more intensive doses of temzolomide as well as combining it with other novel therapies.
* The median is the "middle of the pack", where half of the patients have had more years since treatment and half have less. For instance, if the patients were 2, 4, 6, 10.8, 12, 12 and 14 years since treatment, 10.8 is the mid point, or the median. It is different from the mean, which would be the average time since treatment.
Partially funded by an unrestricted educational grant from Bristol-Myers Squibb.