Clinical characteristics of 3,030 glioblastoma multiforme (GBM) patients in high, upper middle and lower middle economic regions based on real-world data (RWD)

Abstract

Background: GBM is the most common and aggressive primary brain tumor in adults. This study investigated RWD-based differences among 3,030 GBM patients stratified by three economic regions. Methods: The analysis was based on IQVIA syndicated cross-sectional surveys, collecting anonymized patient-level data between January 2016 and September 2017 in different countries, grouped into three economically different regions. Region 1 (high): EU5 (France, Germany, Italy, UK, Spain), Canada, Australia; Region 2 (upper middle): Korea, China, Taiwan; Region 3 (lower middle): Brazil, Mexico. Results: The percentage of patients aged>65 years was 23.9%for region 1, 6.33%for region 2 and 13.62%for region 3, confirming younger GBM population in region 2. The age difference among the regions was statistically significant (P<0.0001). The incidence of male (65 %) and female (35 %) patients was homogenous across all regions. Region 1 showed the highest testing rate (60 %) for MGMTpromoter methylation and region 3 the lowest (33 %). EGFR mutation was not studied in more than 50 %of patients across the regions. However, in overall tested population, the EGFR VIII mutations varied: 39 %, 90 %, and 73%for regions 1, 2 and 3, respectively. Concerning drug treatment options, temozolomide was the leading therapy (> 90 %) in all three regions, regardless ofMGMT and EGFR status. The highest percentage (35 %) for cognitive impairment studied by MMSE (Mini Mental State Examination) was found in region 2, followed by 25%and 22%in regions 1 and 3, respectively. We did not find any differences in Performance Status or comorbidities among the regions, with no reported comorbidities in>60%of patients. Conclusions: This multi-variable analysis from RWD shows differences in clinical characteristics (i.e., age, biomarkers and MMSE), which may be taken into consideration in the design of GBM global studies. To our best knowledge, this study was based on the largest GBM database ever published.