A 60-year-old man undergoes gross total resection of a newly diagnosed MGMT promoter methylated glioblastoma. He then receives concurrent radiotherapy with temozolomide followed by 6 cycles of adjuvant temozolomide. What is the median overall survival expected with this Stupp protocol treatment?

• A 5 to 7 months
• B 10 to 12 months
• C 14.6 to 16.7 months ✓
• D 24 to 30 months

Explanation

The Stupp protocol (concurrent temozolomide-radiotherapy followed by adjuvant temozolomide) for newly established glioblastoma yields a median overall survival of approximately 14.6 to 16.7 months in landmark trials, significantly improved from radiotherapy alone (12.1 months). MGMT promoter methylation predicts greater benefit from temozolomide. Without treatment, median survival is about 5 months. Long-term survivors (>5 years) are rare (Stupp et al., NEJM 2005; NCCN Guidelines).

Reference: Stupp et al., New England Journal of Medicine, 2005;352:987-996 ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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