Trend in incidence, first course of treatment, and survival in patients with glioblastoma.

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e19178 Background: Glioblastoma (GBM) is the most common form of primary brain cancer and notoriously difficult to treat. Over the last 15 years, the population has been aging, yet, there are gaps in analysis of incidence of GBM associated with demographic changes. Further, several important treatment changes over time have led to 3 combined therapies becoming the standard of care since 2005, but their impact on GBM survival are not well established. Methods: The Surveillance, Epidemiology and End Results (SEER) database was analyzed from 2000-2015. We identified 30,955 GBM patients. We calculated the incidence rate and adjusted incidence rate using 2015’s population as a standard, then identified the trends in incidence and treatment using JoinPoint. Survival was analyzed with Kaplan-Meier and Cox proportional hazard models. Results: The incidence of GBM was highest among elderly (≥65yr), followed by adult (19-64yr) and pediatric population (≤18yr) (6.24, 1.64 and 0.10 per 100,000, respectively). The GBM incidence was significantly higher among white than black and other race (2.10 vs. 0.78 vs. 0.77 per 100,000; p < 0.001) and among males than females (2.12 vs. 1.46 per 100,000; p < 0.001). The incidence of GBM has increased from 1.63 to 1.96 (per 100,000) during this period with an annual percent change (APC) of 1.39 (p < 0.001). After adjusting for patient age, the APC was 0.72 (p < 0.001). Combination therapy has increased dramatically since 2000: from 29.3% to 60.9%. Those who underwent all three treatments had better overall survival than those who did not (p < 0.001) after adjusting for comorbidities and demographics. Median survival increased from 7 months (2000-2003) to 11 months (2012-2015) (p < 0.001). In the multivariable model, advanced age, stage, white race, and large tumor size were associated with worse survival, while combination treatment with improved survival (HR = 0.2; CL 0.22-0.24). Conclusions: While there appears to be a growth in the incidence of GBM, it is tempered by the aging of the population. Patients who underwent all three therapies had greater survival than those who did not. Efforts should focus on increasing the proportion of patients who undergo the standard care.