Prognostic impact of obesity in newly-diagnosed glioblastoma: a secondary analysis of CeTeG/NOA-09 and GLARIUS

  • Purpose: The role of obesity in glioblastoma remains unclear, as previous analyses have reported contradicting results. Here, we evaluate the prognostic impact of obesity in two trial populations; CeTeG/NOA-09 (n = 129) for MGMT methylated glioblastoma patients comparing temozolomide (TMZ) to lomustine/TMZ, and GLARIUS (n = 170) for MGMT unmethylated glioblastoma patients comparing TMZ to bevacizumab/irinotecan, both in addition to surgery and radiotherapy. Methods: The impact of obesity (BMI ≥ 30 kg/m2) on overall survival (OS) and progression-free survival (PFS) was investigated with Kaplan–Meier analysis and log-rank tests. A multivariable Cox regression analysis was performed including known prognostic factors as covariables. Results: Overall, 22.6% of patients (67 of 297) were obese. Obesity was associated with shorter survival in patients with MGMT methylated glioblastoma (median OS 22.9 (95% CI 17.7–30.8) vs. 43.2 (32.5–54.4) months for obese and non-obese patients respectively, p = 0.001), but not in MGMT unmethylated glioblastoma (median OS 17.1 (15.8–18.9) vs 17.6 (14.7–20.8) months, p = 0.26). The prognostic impact of obesity in MGMT methylated glioblastoma was confirmed in a multivariable Cox regression (adjusted odds ratio: 2.57 (95% CI 1.53–4.31), p < 0.001) adjusted for age, sex, extent of resection, baseline steroids, Karnofsky performance score, and treatment arm. Conclusion: Obesity was associated with shorter survival in MGMT methylated, but not in MGMT unmethylated glioblastoma patients.

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Author:Johannes WellerORCiD, Niklas SchäferGND, Christina SchaubGND, Anna-Laura PotthoffORCiDGND, Joachim Peter SteinbachORCiDGND, Uwe SchlegelGND, Michael SabelORCiDGND, Peter HauORCiDGND, Clemens SeidelGND, Dietmar KrexGND, Roland GoldbrunnerORCiDGND, Torsten PietschORCiD, Theophilos-Dimitrios TzaridisORCiDGND, Thomas ZeyenGND, Valeri BorgerGND, Erdem Özer GüresirORCiDGND, Hartmut VatterORCiDGND, Ulrich HerrlingerORCiDGND, Matthias SchneiderORCiD
Parent Title (English):Journal of neuro-oncology
Publisher:Springer Science + Business Media B.V
Place of publication:Dordrecht [u.a.]
Document Type:Article
Date of Publication (online):2022/06/15
Date of first Publication:2022/06/15
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2023/02/20
Tag:Glioblastoma; MGMT; Obesity; Temozolomide
Page Number:7
First Page:95
Last Page:101
The involved trials were supported by the German Ministry for Education and Science (CeTeG/NOA-09 [10]), Roche (GLARIUS [12]) and Bundesministerium für Bildung und Forschung (Grant No. 01KG1005). Open Access funding enabled and organized by Projekt DEAL.
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - CC BY - Namensnennung 4.0 International