What is the Prognosis of Glioblastoma?

Glioblastoma, or Glioblastoma  Multiforme (GBM), is an aggressive stage 4 brain cancer.  Nearly half of all malignant brain tumors are glioblastomas. The prognosis for glioblastoma is generally very poor and current treatments often fall short.

Glioblastoma is the most common malignant primary brain tumor, and many refer to it as the “emperor of all cancers.” This is because it is a very difficult disease to treat, and the highly invasive nature of this disease causes significant morbidity and mortality.

Median survival for glioblastoma is one year, with just 50% of glioblastoma patients surviving a year after diagnosis. Glioblastoma prognosis can improve with treatment. Surgery is the mainstay of glioblastoma treatment, followed by oral chemotherapy and radiation. More and more, it is being recognized that patients with glioblastoma do not all have the same prognosis. While many of today’s efforts are focused on identifying molecular markers for prognosis and targeting treatments to specific patients, it is still important to recognize other factors that could also impact the prognosis of glioblastoma.

Extent of surgical resection has been shown to improve survival. Glioblastoma prognosis is closely related to extent of surgical resection.  Improved prognosis is also seen in younger patients, females, those with IDH mutations, those undergoing gross total surgical resection, those with MGMT methylation, and those treated with combination chemotherapy plus radiation.

Age, Gender, Molecular Characteristics, and other Prognostic Indicators

Younger age has been associated with a better prognosis for glioblastoma.  Patients under age 55 have an improved prognosis compared to patients over the age of 55.  Prognosis is also improved for women in comparison to men. Historically, women tend to survive longer than men. Prognosis is also improved for patients undergoing gross total resection and those that have MGMT methylation, among other molecular testing characteristics.

Molecular information can also now be used to determine patient prognosis, and this is consistent with a paradigm shift towards individualized patient management and the heterogenous nature of this disease. Tumor size and location also impact prognosis and survival.

Diagnosis and Treatment

Timing of diagnosis and treatment also influence glioblastoma prognosis.  Early diagnosis and early surgical intervention by a neurosurgeon have been associated with a better prognosis. Glioblastoma prognosis is improved when the time between surgery and diagnosis is minimal, therefore it is recommended that patients see a neurosurgeon as quickly as possible after being diagnosed with glioblastoma.  Aggressive, multi-modal treatment has also been shown to significantly impact prognosis. Similarly, patients’ overall health at the time of diagnosis has also been shown to affect survival and prognosis, and differences in prognosis and survival among patients with glioblastoma consistently depend on age and overall wellness of a patient.

At the Glioblastoma Foundation we are interested in learning more about the differences between long-term and short-term survivors of glioblastoma. We want to know what makes a long-term survivor. The overall prognosis for glioblastoma has changed little since the 1980s, and new treatments are desperately needed to improve outcomes for patients. The Glioblastoma Foundation’s mission is to transform glioblastoma therapy and fund research for new, more effective treatments for this aggressive brain cancer. Donations to the Glioblastoma Foundation go directly to fund the development of targeted drug therapies for Glioblastoma.

While glioblastoma prognosis remains poor, we are making progress against the disease.  We believe precision medicine holds the greatest promise for more effective treatments for glioblastoma.  Treatments that are based on the unique molecular features of a patient’s tumor will be needed in the future to improve both survival and quality of life for patients. At the Glioblastoma Foundation, we are committed to improving the standard of care for this devastating disease and seeing substantial advances in survival and quality of life for patients diagnosed with Glioblastoma.

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