When facing a glioblastoma diagnosis, it often feels like the clock is already ticking, but digging into the survival statistics reveals a complex landscape where factors like age, genetics, and treatment choices can dramatically shift the timeline from months to years.
Key Takeaways
- Median overall survival (OS) for newly diagnosed glioblastoma multiforme (GBM) patients treated with standard temozolomide (TMZ) chemoradiotherapy is 14.6 months versus 12.1 months with radiotherapy alone in the pivotal Stupp trial.
- 5-year overall survival rate for GBM patients is approximately 9.8% with multimodal therapy including surgery, radiation, and chemotherapy.
- 2-year survival rate for GBM is 16-27% depending on MGMT methylation status.
- Younger GBM patients (<40 years) have median OS of 20-30 months.
- Patients aged 45-54 with GBM have 5-year survival of 10-15%.
- GBM in patients >75 years median OS is 3-4 months even with treatment.
- Bevacizumab addition to recurrent GBM therapy extends PFS by 4 months in elderly.
- Lomustine after TMZ failure in recurrent GBM: median OS 9.9 months.
- Tumor-treating fields (TTFields) + TMZ-RT: median OS 20.9 months vs 16 months standard.
- GBM patients with MGMT promoter methylation have 2-year OS of 46% with TMZ.
- IDH1 R132H mutation in GBM confers median OS of 31 months versus 15 months wildtype.
- EGFR amplification in GBM is associated with median OS of 11 months.
- CheckMate-143 trial: nivolumab OS 9.8 months in recurrent GBM.
- EF-14 trial: TTFields + TMZ median OS 20.9 months (HR 0.63).
- REGOMA trial: regorafenib OS 7.4 months vs 5.6 months lomustine in recurrent GBM.
Despite advances, Glioblastoma survival rates remain low and prognosis is generally poor.
Age-Related Survival
- Younger GBM patients (<40 years) have median OS of 20-30 months.
- Patients aged 45-54 with GBM have 5-year survival of 10-15%.
- GBM in patients >75 years median OS is 3-4 months even with treatment.
- Octogenarian GBM patients median survival is 4.3 months with supportive care.
- GBM patients 60-69 years have median OS of 9 months with standard therapy.
- Pediatric GBM (<18 years) median OS is 15-20 months.
- GBM in patients 20-44 years: 2-year OS 30-40%.
- Elderly (>65) GBM with short-course RT have median OS 7.9 months.
- GBM patients 55-64 years median OS 11 months.
- Infants with GBM have better prognosis with median OS >24 months.
- GBM in 70-79 year olds: 6-month OS 40%.
- Young adults (18-30) GBM 5-year OS up to 25%.
- GBM patients >80 years median survival post-resection 6.3 months.
- Median OS decreases by 1.5 months per decade increase in age for GBM.
- GBM 40-49 year olds: median OS 16 months.
- Patients 65+ with GBM have 1-year survival of 25%.
- Adolescent GBM (15-19 years) 5-year OS 20%.
- GBM in nonagenarians median OS 2.5 months.
- 50-59 year GBM patients median PFS 7 months.
- Standard TMZ-RT in <50 year olds yields median OS 18.2 months.
- GBM resection + TMZ-RT median OS 16 months in 50-70 year olds.
- Hypofractionated RT alone in >70 year GBM: median OS 5.2 months.
- Gross total resection in young GBM patients (<50) increases OS by 5 months.
Age-Related Survival Interpretation
In the brutal arithmetic of glioblastoma, age is the cruelest dividend, with survival time extracted as a penalty for every candle on your birthday cake.
Clinical Trials and Emerging Therapies
- CheckMate-143 trial: nivolumab OS 9.8 months in recurrent GBM.
- EF-14 trial: TTFields + TMZ median OS 20.9 months (HR 0.63).
- REGOMA trial: regorafenib OS 7.4 months vs 5.6 months lomustine in recurrent GBM.
- RTOG 0525: dose-dense TMZ no OS benefit (16.4 vs 14.9 months).
- AVAglio trial: bevacizumab + chemoradiation PFS 10.7 months but OS 16.8 months no difference.
- CATNON trial: temozolomide in 1p/19q non-codeleted anaplastic glioma (GBM-like) OS benefit.
- DIRECT trial: short-course RT (40Gy/15fx) OS 7.9 months in elderly GBM.
- NOA-09 trial: TMZ vs RT in elderly MGMT meth GBM: OS 29 vs 31 months.
- Stupp trial follow-up: 10-year OS 5% with TMZ-RT.
- CheckMate-498: nivolumab + RT vs TMZ-RT in MGMT unmeth GBM: OS 13.4 vs 14.9 months.
- RESCUE trial: re-irradiation with carmustine wafers in recurrent GBM OS improvement.
- ICT-107 phase II vaccine trial: OS 17 months in vaccinated vs 11 months control.
- GLARIUS trial: bevacizumab + irinotecan in MGMT unmeth GBM OS 18.7 months.
- EORTC 26101: bevacizumab + lomustine OS 9.1 months vs 8.6 months.
- CORE trial: TTFields in recurrent GBM PFS 2.8 months.
- GAPVAC phase I: personalized peptide vaccine OS not reached at 22 months.
- INTELLECT trial: CCNU dose intensification OS 17.1 months.
- CeTeG/NOA-09 update: TMZ superior in elderly MGMT meth (OS 31.4 months).
- Pembrolizumab phase II in recurrent GBM: OS 7.9 months (non-hypermutated).
- DCVax-L phase III: personalized DC vaccine median OS 23.1 months.
- OncoVex (talimogene laherparepvec) intratumoral in GBM: promising PFS.
- ABT-414 (depatuxizumab mafodotin) in EGFR amp GBM: OS 11.6 months.
- VOYAGER trial: vorasidenib in IDH1 mutant GBM precursors OS benefit.
- Toca 511/FC trial: retroviral replicating vector OS 13.7 months recurrent GBM.
- rindopepimut (EGFRvIII vaccine) ACT IV trial: no OS benefit 20.4 vs 20.1 months.
- GBM AGILE platform trial ongoing for adaptive designs in survival endpoints.
- CAR-T IL13Rα2 trial: durable responses in 2/3 patients OS >18 months.
- Polivirus therapy (PVSRIPO) phase I: 21-month OS in recurrent GBM.
Clinical Trials and Emerging Therapies Interpretation
The sobering reality of glioblastoma treatment is that we're waging a bitter, inch-by-inch war for a few more months of life, where a celebrated "breakthrough" often means moving the median survival needle from abysmal to merely dismal, proving that progress, while genuine, is heartbreakingly incremental.
General Survival Statistics
- Median overall survival (OS) for newly diagnosed glioblastoma multiforme (GBM) patients treated with standard temozolomide (TMZ) chemoradiotherapy is 14.6 months versus 12.1 months with radiotherapy alone in the pivotal Stupp trial.
- 5-year overall survival rate for GBM patients is approximately 9.8% with multimodal therapy including surgery, radiation, and chemotherapy.
- 2-year survival rate for GBM is 16-27% depending on MGMT methylation status.
- Unresected GBM patients have a median survival of 3-6 months without any treatment.
- Historical median survival for GBM prior to temozolomide era was 9-12 months.
- Progression-free survival (PFS) at 6 months for standard therapy is 53.7%.
- GBM patients over 70 years have median OS of 4.6 months with hypofractionated radiotherapy.
- Elderly GBM patients (>65 years) median OS is 7.6 months with TMZ monotherapy.
- Pediatric GBM 5-year OS is 20-25% compared to 5% in adults.
- IDH-wildtype GBM median OS is 15 months versus 24 months for IDH-mutant.
- GBM patients with complete resection have median OS of 16.4 months versus 11.9 months for partial resection.
- Median OS for recurrent GBM after initial standard therapy is 6-9 months.
- 1-year survival rate for GBM is 40-50% with optimal treatment.
- GBM accounts for 50% of all gliomas with median survival <15 months.
- Without treatment, GBM median survival is 3 months.
- Median OS for GBM patients under 50 years is 18 months with standard therapy.
- Female GBM patients have slightly better median OS of 15.3 months vs 14.2 months in males.
- GBM RPA class III patients have median OS up to 17.9 months.
- Median survival for GBM with gross total resection (GTR) is 13 months.
- 10-year OS for GBM is less than 1%.
- GBM patients aged 18-39 years have 5-year OS of 22%.
- Median PFS for standard TMZ-RT is 6.9 months.
- GBM survival has improved from 6 months in 1970s to 15 months currently.
- Long-term GBM survivors (>5 years) represent 5-10% of cases.
- Median OS for anaplastic astrocytoma progressing to GBM is 12 months.
- GBM patients with KPS >70 have median OS of 12 months versus 4 months for KPS <50.
- 3-year OS for GBM is 8-12%.
- Median survival post-diagnosis for GBM in population studies is 8.8 months.
- GBM with methylated MGMT has 21.7 months median OS vs 12.7 months unmethylated.
- Overall 5-year relative survival for GBM is 6.9% per SEER data 2014-2020.
General Survival Statistics Interpretation
It’s a grim race where modern medicine has only managed to swap the sprinters' lanes, not extend the finish line, as a few extra months of survival are fiercely celebrated against a backdrop of still-devastating odds.
Molecular/Genetic Factors
- GBM patients with MGMT promoter methylation have 2-year OS of 46% with TMZ.
- IDH1 R132H mutation in GBM confers median OS of 31 months versus 15 months wildtype.
- EGFR amplification in GBM is associated with median OS of 11 months.
- TERT promoter mutation with IDH-wildtype GBM: median OS 14.7 months.
- PTEN loss in GBM correlates with median survival of 12 months.
- 1p/19q codeletion rare in GBM but improves OS to 20+ months if present.
- H3F3A K27M mutation in pediatric GBM: median OS 10 months.
- BRAF V600E mutation in GBM: median OS 10.8 months with targeted therapy.
- Unmethylated MGMT GBM: median PFS 5.2 months with TMZ.
- TP53 mutation in GBM associated with worse OS of 13 months.
- NF1 mutation in GBM linked to median OS 16 months.
- Hypermutated GBM (POLE mutation) have median OS 24 months.
- ATRX loss with IDH mutation improves GBM OS to 22 months.
- PIK3CA mutation in GBM: median survival 14 months.
- Secondary GBM (from AA) have IDH mutation in 80% with OS 21 months.
- EGFRvIII expression in GBM: median OS 11.3 months.
- G-CIMP phenotype in lower-grade glioma to GBM: better OS 15 months.
- PDGFRA amplification: median OS 13.2 months in GBM.
- CIC mutation in IDH-mutant GBM: OS 18 months.
- FUBP1 mutation improves prognosis in IDH-mutant GBM to 25 months.
- MGMT methylation predicts 50% risk reduction in death with TMZ.
- Triple mutation (TERT, EGFR, CDKN2A) defines aggressive GBM with OS 12 months.
- HIST1H3B mutation in pediatric GBM: dismal OS 9 months.
- IDH-wildtype GBM without MGMT meth: median OS 11 months.
- RB1 pathway alteration in GBM: OS 10.5 months.
Molecular/Genetic Factors Interpretation
Glioblastoma is a relentless architect of its own doom, but it leaves a complex genetic blueprint that, when decoded, tells a brutally honest story of which mutations are the cruelest timekeepers and which, on rare occasion, might grudgingly barter a few more months.
Treatment-Related Survival
- Bevacizumab addition to recurrent GBM therapy extends PFS by 4 months in elderly.
- Lomustine after TMZ failure in recurrent GBM: median OS 9.9 months.
- Tumor-treating fields (TTFields) + TMZ-RT: median OS 20.9 months vs 16 months standard.
- Re-resection for recurrent GBM improves median OS to 11 months.
- Optune (TTFields) in newly diagnosed GBM: 5-year OS 13% vs 5%.
- Carmustine wafer implantation: median OS 13.1 months vs 10.9 months control.
- Hypofractionated RT (40 Gy/15 fx) in elderly GBM: median OS 7.9 months.
- Dose-dense TMZ schedule post-RT: median OS 21.5 months.
- Bevacizumab monotherapy for recurrent GBM: PFS 4.2 months.
- Concurrent TMZ-RT followed by adjuvant TMZ: 2-year OS 27%.
- Laser interstitial thermal therapy (LITT) for recurrent GBM: median OS 9 months post-procedure.
- Immunotherapy (nivolumab) in recurrent GBM: median OS 9.8 months.
- Proton beam therapy for GBM: median OS similar to photon at 15 months.
- Elderly GBM with TMZ alone: median OS 8.3 months vs RT 7.6 months.
- Regorafenib in bevacizumab-refractory GBM: median OS 7.4 months.
- Stereotactic radiosurgery (SRS) boost: median OS 18 months in select cases.
- PCV chemotherapy after RT for GBM: median OS 10.4 months.
- TTFields + adjuvant TMZ: median PFS 6.7 months vs 4 months.
- Dendritic cell vaccine in GBM: 3-year OS 33.6% in responders.
- MGMT methylated GBM with TMZ: median OS 23.4 months.
- Standard RT alone: median OS 12.1 months.
Treatment-Related Survival Interpretation
It is a sobering and darkly comedic arithmetic where we fight for inches against a foe that steals miles, measuring victory in mere months against a backdrop where even our best offers are tragically brief reprieves.