EPID-06. IMPROVEMENTS IN SURVIVAL FOR GLIOBLASTOMA IN THE POST-STUPP PROTOCOL ERA

Abstract

Abstract BACKGROUND Introduction of the Stupp protocol for glioblastoma treatment in 2005 led to a significant increase in overall survival in glioblastoma. Prior analyses identified additional survival gains in glioblastoma since this time, though the source of these gains is unknown. In this analysis, we leveraged commercial claims and population-based datasets to better understand potential treatment factors associated with improved survival for glioblastoma. METHODS Provider-side commercial claims data were obtained from IQVIA for adults (18+) diagnosed with malignant brain tumor (ICD-9 codes: 191.0-191.9 or ICD-10 codes: C71.0-C71.9) from 2013-2021. Glioblastoma patients were identified as those who received biopsy/resection, radiation and temozolomide within 60 days of their brain tumor diagnosis. Treatment patterns were determined using ICD-9/ICD-10 procedure codes and HCPCS/CPT codes. Date of death was determined by a claim containing the CPT codes 99238 or 99239 or date of last claim followed by at least 30 days of no additional claims. Population-based survival data for microscopically-confirmed adult glioblastoma cases receiving radiation treatment from the National Program of Cancer Registries (NPCR) from 2004-2018 were used as a comparison group. Median survival was estimated using Kaplan-Meier regression, overall in IQVIA and by two-year periods in NPCR. RESULTS In the IQVIA cohort, 9,368 individuals (2.5%) were identified as glioblastoma based on treatment criteria. Median survival in the IQVIA cohort 16.6 months (15.2-17.0), and 12 months (95%CI:12-12) in NPCR. Median survival in NPCR increased from 11 months in 2004-2006, to 12 months in 2006-2009, and then 13 months in 2010-2018. Within the IQVIA cohort, 27% had ≥ 1 claim for Bevacizumab and 15% had ≥ 1 claim for tumor treating fields. CONCLUSIONS Survival in glioblastoma continues to improve over time, which may be due to developments of new therapeutic approaches. Assessment of population-level survival patterns is essential for understanding the impact of treatment advancements in the general population.