Impact of molecular and clinical variables on survival outcome with immunotherapy for glioblastoma patients: A systematic review and meta-analysis.

Abstract

BACKGROUND:

Given that only a subset of patients with glioblastoma multiforme (GBM) responds to immuno-oncology, this study aimed to assess the impact of multiple factors on GBM immunotherapy prognosis and investigate the potential predictors.

METHODS:

A quantitative meta-analysis was conducted using the random-effects model. Several potential factors were also reviewed qualitatively.

RESULTS:

A total of 39 clinical trials were included after screening 1317 papers. Patients with O6-methylguanine-DNA methyltransferase (MGMT) promoter methylation [hazard ratio (HR) for overall survival (OS) = 2.30, p < 0.0001; HR for progression-free survival (PFS) = 2.10, p < 0.0001], gross total resection (HR for OS = 0.70, p = 0.02; HR for PFS = 0.56, p = 0.004), and no baseline steroid use (HR for OS = 0.52, p = 0.0002; HR for PFS = 0.61, p = 0.02) had a relatively significant favorable OS and PFS following immunotherapy. Patients with a Karnofsky Performance Status score < 80 (HR = 1.73, p = 0.0007) and undergoing two prior relapses (HR = 2.08, p = 0.003) were associated with worse OS. Age, gender, tumor programmed death-ligand 1 expression, and history of chemotherapy were not associated with survival outcomes. Notably, immunotherapy significantly improved the OS among patients undergoing two prior recurrences (HR = 0.40, p = 0.008) but not among patients in any other subgroups, as opposed to non-immunotherapy.

CONCLUSION:

Several factors were associated with prognostic outcomes of GBM patients receiving immunotherapy; multiple recurrences might be a candidate predictor. More marker-driven prospective studies are warranted.

• Authors: Wentao Hu, Hongyu Liu, Ze Li, Jialin Liu, Ling Chen
• Journal: CNS neuroscience & therapeutics (CNS Neurosci Ther) Vol. 28 Issue 10 Pg. 1476-1491 (10 2022) ISSN: 1755-5949 [Electronic] England
• PMID: 35822692 (Publication Type: Journal Article, Meta-Analysis, Review, Systematic Review, Research Support, Non-U.S. Gov't)
• Copyright: © 2022 The Authors. CNS Neuroscience & Therapeutics published by John Wiley & Sons Ltd.

Chemical References

• DNA Modification Methylases

Topics

• Brain Neoplasms (genetics, therapy)
• DNA Methylation
• DNA Modification Methylases (genetics)
• Glioblastoma (genetics, therapy)
• Humans
• Immunotherapy
• Neoplasm Recurrence, Local (genetics)
• Prognosis