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Review
. 2023 Aug:188:104065.
doi: 10.1016/j.critrevonc.2023.104065. Epub 2023 Jun 29.

The impact of survivorship bias in glioblastoma research

Francesco Pasqualetti  1 , Alessandro Barberis  2 , Sofia Zanotti  3 , Nicola Montemurro  4 , Gian Luca De Salvo  5 , Riccardo Soffietti  6 , Chiara Maria Mazzanti  7 , Tamara Ius  8 , Maria Caffo  9 , Fabiola Paiar  10 , Guido Bocci  11 , Giuseppe Lombardi  12 , Adrian L Harris  13 , Francesca M Buffa  14
Affiliations
Review

The impact of survivorship bias in glioblastoma research

Francesco Pasqualetti et al. Crit Rev Oncol Hematol. 2023 Aug.

Abstract

Despite advances in the therapy of Central Nervous System (CNS) malignancies, treatment of glioblastoma (GB) poses significant challenges due to GB resistance and high recurrence rates following post-operative radio-chemotherapy. The majority of prognostic and predictive GB biomarkers are currently developed using tumour samples obtained through surgical interventions. However, the selection criteria adopted by different neurosurgeons to determine which cases are suitable for surgery make operated patients not representative of all GB cases. Particularly, geriatric and frail individuals are excluded from surgical consideration in some cancer centers. Such selection generates a survival (or selection) bias that introduces limitations, rendering the patients or data chosen for downstream analyses not representative of the entire community. In this review, we discuss the implication of survivorship bias on current and novel biomarkers for patient selection, stratification, therapy, and outcome analyses.

Keywords: Biomarkers; Glioblastoma; Liquid biopsy; Methodology; O6-methylguanine-DNA methyltransferase (MGMT) methylation; Research; Selection bias; Translational research.

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Conflict of interest statement

Declaration of Competing Interest The authors whose names are listed immediately below certify that they have NO affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.