Short-Course Radiation Therapy Shows Promise for Older Glioblastoma Patients
A groundbreaking phase 2 trial has revealed that a short-course of hypofractionated proton beam therapy, enhanced by 18F-DOPA PET imaging, significantly improves overall survival (OS) in patients aged 65 and older with newly diagnosed glioblastoma. This innovative approach not only offers a more efficient treatment regimen but also reduces the social and financial burdens on patients and their caregivers.
Study Overview
The trial, conducted between May 22, 2019, and May 25, 2021, involved 39 patients who received the novel treatment regimen. By the data cutoff on January 30, 2024, the median follow-up was 25.4 months, with 22 out of 39 patients alive at the 12-month mark. The median OS was reported at 13.1 months, showcasing a significant improvement over historical controls.
Safety and Efficacy
Regarding safety, the treatment was well-tolerated, with no treatment-associated grade 4 adverse effects (AEs) or deaths reported. However, four patients experienced grade 3 central nervous system (CNS) necrosis, and one patient developed grade 3 thrombocytopenia. These findings underscore the treatment's acceptable AE profile, especially considering the older patient population involved.
Implications for Glioblastoma Treatment
Glioblastoma, accounting for 49% of malignant CNS cases among adults in the U.S., presents a significant challenge, particularly in older patients who have worse survival rates. The study's authors highlighted the importance of improved targeting techniques, such as the use of 18F-DOPA PET, in reducing treatment margins and facilitating dose escalation of metabolically active areas. This approach, combined with proton beam therapy, represents a significant step forward in the treatment of glioblastoma.
Future Directions
The promising results of this phase 2 trial have paved the way for a phase 2 study comparing this regimen with standard-of-care treatment in adults of any age with newly diagnosed glioblastoma. This ongoing research aims to further validate the efficacy and safety of short-course, hypofractionated proton beam therapy, potentially revolutionizing the management of this devastating disease.
Conclusion
The findings from this trial offer hope for older patients with glioblastoma, providing a treatment option that not only improves survival but also minimizes the treatment burden. As research continues, the potential for this regimen to become a new standard of care in glioblastoma treatment is increasingly evident.
