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Surviving glioblastoma? EORTC Brain Tumour Group explores the factors that contribute to long-term survival

GLIOBLASTOMAS represent almost 50% of malignant primary brain tumors in adults, and range among the most lethal cancer types. Approximately three in 100,000 people a year are diagnosed with a glioblastoma. These tumors mainly affect patients in later life, but can occur in younger adults and even in children. Due to the aggressive nature of this tumor, which invades the brain by infiltration and destroys healthy brain tissue, glioblastomas lead to a significantly reduced life span with sometimes considerable loss of quality of life. Almost half of the patients die in the first year of diagnosis, despite the use of a broad therapeutical approach including brain surgery, radiotherapy and sometimes several courses of chemotherapy. Yet, a small percentage of up to 5% of all patients suffering from glioblastoma may survive for more than five years. These patients are referred to as long-term survivors.

The reasons leading to this survival benefit in this heterogeneous patient group have not been fully identified so far. These patients are now the focus of EORTC 1419, also known as ETERNITY, a large international comprehensive study, assessing potential clinical and biological factors of this long-term survival that may contribute to improved survival in glioblastoma patients in general. Considering the rareness of glioblastoma long-term survival, a multicenter approach, involving a large number of clinical centers collecting patient data, is required. This EORTC study was made possible by a generous grant of US $2,000,000 by the Brain Tumor Funders’ Collaborative (BTFC). The BTFC is a strategic partnership of five private philanthropic and advocacy organisations in the US and Canada: the American Brain Tumor Association, Brain Tumour Foundation of Canada, Children’s Brain Tumor Foundation, James S. McDonnell Foundation, and the Sontag Foundation. EORTC 1419 comprises 33 leading centers for neuro-oncology worldwide, including centers in Europe, Australia and the US.

The participating medical researchers collect extensive clinical data from over 400 patients who survived their disease for more than five years. They record additional information including patient histories and health-related data, and perform extensive neurocognitive assessments to allow for a better understanding of the implications of the disease as well as the therapies in affected patients. Tumor tissue and blood samples from these patients will be collected to study the genetic and immunologic features of glioblastomas. Moreover, an analysis of all neuroimaging studies available from the selected patient group will be performed, assessing tumor growth patterns and development by different imaging tools. All the acquired information will later be compared to the data set of a reference cohort of glioblastoma patients who have not become long-term survivors. The collected clinical data will be inserted in a large database for further comparative analysis. In parallel, all available tissue samples will be catalogued in a central biobank in Germany, and sorted for the planned molecular and genetic investigations. The knowledge gained from this study will allow for a better understanding of the disease, and should help develop better treatment strategies for all glioblastoma patients in the future (contact: Michael.weller@usz.ch, 1419@eortc.be).

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