1. A case series of osseous metastases in patients with glioblastoma.
- Author
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Webb LM, Webb MJ, Campian JL, Caron SJ, Ruff MW, Uhm JH, and Sener U
- Subjects
- Humans, Male, Middle Aged, Female, Adult, Retrospective Studies, Aged, Aged, 80 and over, Young Adult, Prognosis, Bevacizumab therapeutic use, Tumor Suppressor Protein p53 genetics, DNA Repair Enzymes genetics, DNA Modification Methylases, Tumor Suppressor Proteins, Glioblastoma genetics, Glioblastoma secondary, Glioblastoma pathology, Glioblastoma therapy, Bone Neoplasms secondary, Bone Neoplasms genetics, Brain Neoplasms secondary, Brain Neoplasms genetics, Brain Neoplasms therapy
- Abstract
Background: Extracranial metastases occur in <2% of cases of glioblastoma (GBM). When metastases do occur, bone is the most common destination. Herein, we review clinical characteristics of GBM patients with osseous metastases and evaluate both potential risk factors and prognostic significance., Methods: Using an institutional database, we identified and retrospectively analyzed 6 patients with both GBM and osseous metastases. We collected data on patient demographics, tumor genetics, clinical courses, and outcomes. Given the rarity of metastatic GBM, we conducted historical comparisons using previously published literature., Results: Five patients with osseous metastases (83%) were male, with a median age of 46 years at GBM diagnosis (range: 20-84). All patients had IDH-wildtype, MGMT promoter unmethylated GBM and 5 (83%) had alterations in TP53. All patients underwent surgical resection for GBM followed by radiation with concurrent and adjuvant temozolomide. Four patients (67%) received bevacizumab prior to bone metastasis diagnosis. Bone metastases were discovered at a median of 12.2 months (range: 5.3-35.2) after GBM diagnosis and 4.8 months after starting bevacizumab (range: 3.5-13.2). Three patients (50%) received immunotherapy. After osseous metastasis diagnosis, the median survival was 25 days (range: 13-225)., Conclusion: In our cohort, most patients were male and young at the time of GBM diagnosis. All patients had IDH-wildtype, MGMT promoter unmethylated GBM, and most had alterations in TP53, which may be important for osseous metastasis. Most patients received bevacizumab, which has been associated with earlier metastasis. Osseous metastases of GBM occur and portend a dismal prognosis in an already aggressive malignancy., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)
- Published
- 2024
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