Progression-free survival versus post-progression survival and overall survival in WHO grade 2 gliomas

Authors

  • Lisa Millgård Sagberg Department of Neurosurgery, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway; Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway https://orcid.org/0000-0001-7149-3082
  • Øyvind Salvesen Clinical Research Unit, Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
  • Asgeir Store Jakola Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden; Institute of Neuroscience and Physiology, Department of Clinical Neuroscience, Sahlgrenska Academy, Gothenburg, Sweden
  • Erik Thurin Institute of Neuroscience and Physiology, Department of Clinical Neuroscience, Sahlgrenska Academy, Gothenburg, Sweden; Department of Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden
  • Eddie de Dios Institute of Neuroscience and Physiology, Department of Clinical Neuroscience, Sahlgrenska Academy, Gothenburg, Sweden; Department of Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden
  • Noah L.A. Nawabi Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
  • John L. Kilgallon Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
  • Joshua D. Bernstock Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
  • Vasileios K. Kavouridis Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
  • Timothy R. Smith Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
  • Ole Solheim Department of Neurosurgery, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway; Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway

DOI:

https://doi.org/10.2340/1651-226X.2024.40845

Keywords:

Brain Neoplasms, Surrogate endpoints, Response assessment criteria, Prognostic factors, Oncology

Abstract

Background and purpose: Progression-free survival (PFS) remains to be validated as an outcome measure for diffuse WHO grade 2 gliomas, and knowledge about the relationships between PFS, post-progression survival (PPS), and overall survival (OS) in this subset of tumors is limited. We sought to assess correlations between PFS and OS, and identify factors associated with PFS, PPS, and OS in patients treated for diffuse supratentorial WHO grade 2 gliomas.

Material and methods: We included 319 patients from three independent observational cohorts. The correlation between PFS and OS was analyzed using independent exponential distributions for PFS and time from progression to death. Cox proportional hazards models were used to determine the effects of covariates on PFS, PPS, and OS.

Results: The overall correlation between PFS and OS was rs0.31. The correlation was rs 0.37 for astrocytomas and rs 0.19 for oligodendrogliomas. Longer PFS did not predict longer PPS. Patients with astrocytomas had shorter PFS, PPS, and OS. Larger preoperative tumor volume was a risk factor for shorter PFS, while older age was a risk factor for shorter PPS and OS. Patients who received early radio- and chemotherapy had longer PFS, but shorter PPS and OS.

Interpretation: We found a weak correlation between PFS and OS in WHO grade 2 gliomas, with the weakest correlation observed in oligodendrogliomas. Our analyses did not demonstrate any association between PFS and PPS. Critically, predictors of PFS are not necessarily predictors of OS. There is a need for validation of PFS as an endpoint in diffuse WHO grade 2 gliomas.

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Published

2024-10-20

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Sagberg, L. M., Salvesen, Øyvind, Jakola, A. S., Thurin, E., de Dios, E., Nawabi, N. L., … Solheim, O. (2024). Progression-free survival versus post-progression survival and overall survival in WHO grade 2 gliomas. Acta Oncologica, 63(1), 798–804. https://doi.org/10.2340/1651-226X.2024.40845

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Vol. 63 (2024): Acta Oncologica

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Original article

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Copyright (c) 2023 Lisa Millgård Sagberg, Øyvind Salvesen, Asgeir Store Jakola, Erik Thurin, Eddie de Dios, Noah L.A. Nawabi, John L. Kilgallon, Joshua D. Bernstock, Vasileios K. Kavouridis, Timothy R. Smith, Ole Solheim

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