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. 2019 May-Dec;1(1):vdz007.
doi: 10.1093/noajnl/vdz007. Epub 2019 May 30.

An independently validated nomogram for isocitrate dehydrogenase-wild-type glioblastoma patient survival

Haley Gittleman  1   2 , Gino Cioffi  1 , Pranathi Chunduru  3 , Annette M Molinaro  3 , Mitchel S Berger  3 , Andrew E Sloan  2   4   5 , Jill S Barnholtz-Sloan  1   2
Affiliations

An independently validated nomogram for isocitrate dehydrogenase-wild-type glioblastoma patient survival

Haley Gittleman et al. Neurooncol Adv. 2019 May-Dec.

Abstract

Background: In 2016, the World Health Organization reclassified the definition of glioblastoma (GBM), dividing these tumors into isocitrate dehydrogenase (IDH)-wild-type and IDH-mutant GBM, where the vast majority of GBMs are IDH-wild-type. Nomograms are useful tools for individualized estimation of survival. This study aimed to develop and independently validate a nomogram for IDH-wild-type patients with newly diagnosed GBM.

Methods: Data were obtained from newly diagnosed GBM patients from the Ohio Brain Tumor Study (OBTS) and the University of California San Francisco (UCSF) for diagnosis years 2007-2017 with the following variables: age at diagnosis, sex, extent of resection, concurrent radiation/temozolomide (TMZ) status, Karnofsky Performance Status (KPS), O6-methylguanine-DNA methyltransferase (MGMT) methylation status, and IDH mutation status. Survival was assessed using Cox proportional hazards regression, random survival forests, and recursive partitioning analysis, with adjustment for known prognostic factors. The models were developed using the OBTS data and independently validated using the UCSF data. Models were internally validated using 10-fold cross-validation and externally validated by plotting calibration curves.

Results: A final nomogram was validated for IDH-wild-type newly diagnosed GBM. Factors that increased the probability of survival included younger age at diagnosis, female sex, having gross total resection, having concurrent radiation/TMZ, having a high KPS, and having MGMT methylation.

Conclusions: A nomogram that calculates individualized survival probabilities for IDH-wild-type patients with newly diagnosed GBM could be useful to physicians for counseling patients regarding treatment decisions and optimizing therapeutic approaches. Free software for implementing this nomogram is provided: https://gcioffi.shinyapps.io/Nomogram_For_IDH_Wildtype_GBM_H_Gittleman/.

Keywords: IDH-wild-type; glioblastoma; nomogram; survival.

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Figures

Fig. 1
Fig. 1
Kaplan–Meier survival curves for isocitrate dehydrogenase-wild-type newly diagnosed glioblastoma patients from the Ohio Brain Tumor Study and the University of California San Francisco, 2007–2017 (A) unadjusted and (B) adjusted for age at diagnosis and Karnofsky Performance Status.
Fig. 2
Fig. 2
Validated nomogram for predicted 12-, 18-, and 24-month survival for newly diagnosed isocitrate dehydrogenase-wild-type glioblastoma patients; the Ohio Brain Tumor Study, 2007–2017.
Fig. 3
Fig. 3
Calibration curves for training data (the Ohio Brain Tumor Study) for predicted (A) 12-, (B) 18-, and (C) 24-month survival and testing data (University of California San Francisco) for predicted (D) 12-, (E) 18-, and (F) 24-month survival for isocitrate dehydrogenase-wild-type newly diagnosed glioblastoma patients, 2007–2017.
See this image and copyright information in PMC

References

    1. Thakkar JP, Dolecek TA, Horbinski C, et al. . Epidemiologic and molecular prognostic review of glioblastoma. Cancer Epidemiol Biomarkers Prev. 2014;23(10):1985–1996. - PMC - PubMed
    1. Gaist D, Hallas J, Friis S, Hansen S, Sørensen HT. Statin use and survival following glioblastoma multiforme. Cancer Epidemiol. 2014;38(6):722–727. - PubMed
    1. Heimberger AB, Hlatky R, Suki D, et al. . Prognostic effect of epidermal growth factor receptor and egfrviii in glioblastoma multiforme patients. Clin Cancer Res. 2005;11(4):1462–1466. - PubMed
    1. Ostrom QT, Gittleman H, Truitt G, Boscia A, Kruchko C, Barnholtz-Sloan JS. CBTRUS statistical report: primary brain and other central nervous system tumors diagnosed in the United States in 2011–2015. Neuro Oncol. 2018;20(suppl_4):iv1–iv86. - PMC - PubMed
    1. Schiffgens S, Wilkens L, Brandes AA, et al. . Sex-specific clinicopathological significance of novel (frizzled-7) and established (MGMT, IDH1) biomarkers in glioblastoma. Oncotarget. 2016;7(34):55169–55180. - PMC - PubMed