P02.03 Real-world treatment patterns in glioblastoma multiforme (GBM)

Abstract

Objectives: To understand real-world utilization of treatments for GBM. METHODOLOGY: Real-world data were collected through a cross-sectional survey administered to physicians in Canada, France, Germany, and the UK between May and July 2016. Physicians provided data for eight consecutive patients receiving treatment for GBM regarding disease history, characteristics, and treatment patterns. Summary statistics were reported and differences assessed using chi-square tests. Results: A total of 161 physicians (Canada, 29; France, 52; Germany, 50; and UK, 30) provided information for 1,235 GBM patients (Canada, 195; France, 400; Germany, 400; and UK, 240). Nearly half (45%) of all patients presented with stable disease, while 28% were classified as progressing and the remaining 28% as responding to treatment. Forty-five percent of patients had experienced a recurrence. Methylation status was evaluated in 70% of patients with 59% of these showing gene promoter methylation. Approximately two-thirds (67%) of patients had undergone surgery of whom 88% had been operated on prior to initiation of drug treatment. More than three-quarters of patients had received treatment with radiotherapy Ninety percent of patients received first-line treatment with temozolomide (TMZ), while the remainder were treated with bevacizumab (BEV) (5%); a procarbazine, lomustine, and vincristine (PCV) regimen (4%); or irinotecan (IRI) (1%). 613 patients received second-line therapy of whom 36% were treated with BEV (alone or in regimen), 22% with TMZ or PCV, and 13% with IRI. BEV use varied among countries with a prevalence of 49% in France, 38% in Germany, 35% in Canada, and 10% in the UK (p <0.001). Use of BEV in second line was higher among patients with progressive disease than those with stable disease (43% vs. 28%, p<0.001). However, there was no difference in BEV use between patients with progressed or treatment-responsive disease (43% vs. 35%, p=0.188). Similarly, there was no difference in the prevalence of second-line BEV use between patients with or without gene promoter methylation (40% in each group, p=0.962). Only 45 patients received third-line therapy of whom 51% were treated with BEV (alone or in regimen), 16% IRI, 13% TMZ, and 4% PCV. By country, the prevalence of BEV use varied with 62% in France, 55% in Canada, 50% in Germany, and 17% in the UK. CONCLUSION: Real-world data collected in Canada, France, Germany, and the UK indicate that TMZ is the most commonly used first-line treatment for GBM, whereas BEV is most commonly prescribed in second and later lines. The high prevalence of BEV use underscores the need for more effective therapies.