Glioblastoma is an aggressive and lethal type of brain cancer that appears in people of all ages. According to the World Health Organisation, glioblastomas are classified as Grade IV and represent (along with grade III gliomas) the majority of brain tumours . Overall, glioblastomas incidence is 1 per 10 000 cases among all cancer types. However, they represent 16% of all primary brain tumours, making them the most common brain cancer and almost always the most lethal [2, 3, 4]. Today, long-term glioblastoma survivors are defined as patients who live longer than 2 years following their diagnosis whereas extreme survivors, living 10 years or more, account for 1% of all patients . This EORTC trial was instrumental to the prolonged survival of glioblastoma patients and remains the standard of care to this date.
Prior to this EORTC trial, the only available treatment involved surgery to remove the tumour followed by radiotherapy of the brain. This treatment however had very little impact on patients’ survival. The EORTC trial successfully showed that a drug called temozolomide, when taken as a pill after surgery and in addition to radiotherapy, allowed many patients to live longer. In addition, taking this pill did not cause too many adverse effects to patients, who reported on average that their quality of life was not worse than that reported by the patients not taking the drug.
Since a large number of patients saw an improvement by taking this drug, researchers tried to identify ways they could predict which patients would benefit (i.e., live longer) from this treatment and which have less chance of doing so. They succeeded in identifying a gene as the first predictive marker in brain tumours (called MGMT promoter methylation) associated with a better response to the treatment. To date, this molecular test is used in all patients with glioblastoma and was the one that introduced the concept of personalised treatment in neuro-oncology. This personalised combination treatment became the standard of care for newly diagnosed glioblastoma patients worldwide.
Study coordinator: Prof. Roger Stupp