Work

Ncog-19. Sex Differences in Glioblastoma Treatment and Adverse Events

Year: 2023

Type: article

Abstract: Despite aggressive therapies, the survival rates for gliomas remain complex and accumulating evidence indicates that there are sex differences in patient response to treatment and the development of adverse events (AE). We utilized the Surveillance, Epidemiology and End. RESULTS: Program (SEER)-Medicare dataset to examine sex differences in treatment patterns and AEs in patients 65 years and older diagnosed with glioblastoma. We identified 15,693 individuals (≥65 years) diagnosed with glioblastoma between 2004-2017. Sex differences were assessed based upon their treatment modality: no-treatment (NT), standard treatment (ST) (surgery + radiation + chemotherapy), or other treatment (OT) (any other combination of surgery, radiation and/or chemotherapy). Multivariable models were used to determine the odds of males versus females experiencing an AE by treatment group. Sex differences in survival were assessed using Kaplan-Meier and Cox proportional hazards models. There was a significant sex difference in the type of treatment received by glioblastoma patients, with males receiving more ST than females (38% v 34%; p< 0.001). Females treated with ST had increased odds of rheumatoid arthritis or collagen vascular disease (OR=0.42; 95%CI, 0.30-0.59; p< 0.001). Females receiving OT had an increased odds of rheumatoid arthritis or collagen vascular disease (OR=0.59; 95%CI, 0.44-0.78; p< 0.001), and mood disorders (OR=0.81; 95%CI, 0.72-0.90; p< 0.001). Males receiving NT had an increased odds of blood disorders (OR=1.48; 95% CI, 1.12-1.96; p=0.006), cardiac events when treated with ST (OR=1.24; 95%CI, 1.10-1.41; p< 0.001), and respiratory events when treated with OT (OR=1.20; 95%CI, 1.07-1.35; p=0.002). Females with glioblastoma, receiving ST had an increased adjusted overall survival compared to males (p< 0.001), whereas no sex difference were observed in those receiving OT or NT. Our analysis demonstrates that there are sex differences in odds of AE and overall survival associated glioblastoma treatment, which could impact clinical treatment decisions.

Source: Neuro-Oncology

DOI: 10.1093/neuonc/noad179.0832