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. 2021 Dec;155(3):363-372.
doi: 10.1007/s11060-021-03886-5. Epub 2021 Nov 10.

Independently validated sex-specific nomograms for predicting survival in patients with newly diagnosed glioblastoma: NRG Oncology RTOG 0525 and 0825

Nirav Patil #  1 , Eashwar Somasundaram #  2 , Kristin A Waite  3 , Justin D Lathia  4   5 , Mitchell Machtay  6 , Mark R Gilbert  7 , James R Connor  6 , Joshua B Rubin  8 , Michael E Berens  9 , Robin A Buerki  1 , Serah Choi  1 , Andrew E Sloan  1   2   5 , Marta Penas-Prado  10 , Lynn S Ashby  11 , Deborah T Blumenthal  12 , Maria Werner-Wasik  13 , Grant K Hunter  14 , John C Flickinger  15 , Merideth M Wendland  16 , Valerie Panet-Raymond  17 , H Ian Robins  18 , Stephanie L Pugh  19 , Minesh P Mehta  20 , Jill S Barnholtz-Sloan  21   22   23   24
Affiliations

Independently validated sex-specific nomograms for predicting survival in patients with newly diagnosed glioblastoma: NRG Oncology RTOG 0525 and 0825

Nirav Patil et al. J Neurooncol. 2021 Dec.

Abstract

Background/purpose: Glioblastoma (GBM) is the most common primary malignant brain tumor. Sex has been shown to be an important prognostic factor for GBM. The purpose of this study was to develop and independently validate sex-specific nomograms for estimation of individualized GBM survival probabilities using data from 2 independent NRG Oncology clinical trials.

Methods: This analysis included information on 752 (NRG/RTOG 0525) and 599 (NRG/RTOG 0825) patients with newly diagnosed GBM. The Cox proportional hazard models by sex were developed using NRG/RTOG 0525 and significant variables were identified using a backward selection procedure. The final selected models by sex were then independently validated using NRG/RTOG 0825.

Results: Final nomograms were built by sex. Age at diagnosis, KPS, MGMT promoter methylation and location of tumor were common significant predictors of survival for both sexes. For both sexes, tumors in the frontal lobes had significantly better survival than tumors of multiple sites. Extent of resection, and use of corticosteroids were significant predictors of survival for males.

Conclusions: A sex specific nomogram that assesses individualized survival probabilities (6-, 12- and 24-months) for patients with GBM could be more useful than estimation of overall survival as there are factors that differ between males and females. A user friendly online application can be found here- https://npatilshinyappcalculator.shinyapps.io/SexDifferencesInGBM/ .

Keywords: Glioblastoma; Nomogram; Sex differences; Survival.

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Conflict of interest statement

Drs. Ashby, Barnholtz-Sloan, Berens, Blumenthal, Buerki, Choi, Connor, Flickinger, Gilbert, Hunter, Lathia, Machtay, Panet-Raymond, Patil, Penas-Prado, Robins, Rubin, Sloan, Somasundaram, Waite, Wendland and Werner-Wasik have nothing to disclose. Dr. Mehta reports personal (consultant) fees from Mevion, Karyopharm, Tocagen, Astra Zeneca, Blue Earth Diagnostics, Board of Directors from Oncoceutics (with options) outside the submitted work. Dr. Pugh reports Salary support paid to my institution from Millennium, and Pfizer, outside the submitted work.

Figures

Fig. 1
Fig. 1
Kaplan–Meier Survival Results by Sex for Overall and Progression-Free Survival Using Training (NRG/RTOG 0525) (A and B) and Validation (NRG/RTOG 0825) (C and D) datasets
Fig. 2
Fig. 2
Final nomogram of Overall Survival for Males built on training data (NRG/RTOG 0525) and independently validated on NRG/RTOG 0825
Fig. 3
Fig. 3
Final nomogram of Overall Survival for Females built on training data NRG/RTOG 0525 and independently validated on NRG/RTOG 0825
See this image and copyright information in PMC

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