Evolving Practice and Outcomes in Grade 2 Glioma: Real-World Data from a Multi-Institutional Registry

Area of Science:

• Neuro-oncology
• Clinical Research
• Brain Tumor Epidemiology

Background:

• Grade-2 gliomas (G2-glioma) are rare brain tumors.
• The RTOG9802 trial established chemoradiotherapy (CRT) as standard for high-risk G2-glioma (subtotal resection or age ≥40).
• Current real-world treatment practices for G2-glioma are not well-documented.

Purpose of the Study:

• To report current clinical practices for G2-glioma management using real-world data.
• To assess trends in treatment utilization over time.
• To evaluate the impact of CRT on progression-free survival (PFS) in high-risk G2-glioma patients.

Main Methods:

• A prospective clinical registry (BRAIN) identified 224 G2-glioma patients diagnosed between January 2016 and December 2022.
• Patients were categorized as high-risk or low-risk based on RTOG9802 criteria.
• Survival outcomes were analyzed using Kaplan-Meier methods, comparing two time periods (TP1: 2016-2019, TP2: 2020-2022).

Main Results:

• Of 186 high-risk patients, 52% were observed, 34% received CRT, and 10% received radiation alone.
• CRT utilization increased from 22% in TP1 to 36% in TP2 (p=0.004).
• High-risk patients receiving CRT had significantly longer median PFS compared to observation (HR 0.49, p=0.007).

Conclusions:

• Real-world data confirms CRT improves PFS in high-risk G2-glioma, aligning with RTOG9802 findings.
• Despite increased CRT use, observation post-surgery is still the predominant strategy.
• Validated biomarkers are crucial for optimizing G2-glioma patient management.