Metastasis from glioblastoma multiforme: a meta-analysis

Abstract

SUMMARY OBJECTIVE: Extracranial metastases of glioblastoma multiforme (GBM) are rare due to the short survival experienced by the patients. Therefore, the natural history of GBM metastases remains elusive. The identification of clinical factors promoting GBM metastases may help elucidate the mechanisms of tumor cell invasion in the brain. The aims of this study were to perform a meta-analysis evaluating the survival, characteristics, prognostic factors, and predictors of treatment outcome in patients with metastatic GBM and describe a case of metastatic extracranial GBM. METHODS: We report the case of a patient diagnosed with GBM metastatic to the lungs and the results of a meta-analysis of 114 other cases of metastatic GBM identified through a MEDLINE and BIREME search. RESULTS: The mean age of the patients was 38.2±16.1 years and 70.4% were male. The time elapsed between the identification of the metastasis and death was significantly increased in patients undergoing surgery (p=0.019), whereas the time from the diagnosis of the primary tumor to death was significantly increased in patients receiving radiation therapy (p=0.050). The time elapsed from metastasis to death and diagnosis to death was significantly longer in patients receiving chemotherapy (p<0.001 and p=0.027, respectively). The liver was the metastatic site associated with the shortest time elapsed from diagnosis to death (p=0.024). CONCLUSIONS: In GBM, surgical resection is important in reducing the risk of metastasis, and chemotherapy and radiation therapy help to prolong survival in metastatic GBM. Metastases to the liver are associated with shorter survival compared with metastases to other sites.

Molecular profiling of an osseous metastasis in glioblastoma during checkpoint inhibition: potential mechanisms of immune escape

“…In order to form extracranial metastases, the tumour had to, either gain new genetic drivers to promote peripheral metastatic seeding, or suppress the peripheral immunosurveillance, or develop new mechanisms to evade from immune recognition during its metastatic spread, or both. Multiple case reports of GBM metastases have focused on genetic aberrations, potentially involved in tumour cell manifestation outside the brain [11,43,45]. Among others, alterations, such as BRCA1 and ARID1A mutations or overexpression of IGFBP2 have been described in these cases [44,45].…”

Extracranial metastases in secondary glioblastoma multiforme: a case report

“…IDH wild-type (primary) GBM develops de novo in elderly (60-80 years) patients representing approximately the 90% of all cases of GBM, while IDH mutant (secondary) GBM is typical of younger people, has a more positive biomolecular pattern and is associated with a better prognosis [1]. Despite its highly invasive nature, GBM metastases are rare and this is putatively attributed to the short overall survival and the lack of a favorable environment for an extracranial spreading of tumor cells [2,3]. Moreover, metastases usually occur after primary GBM, while extracranial involvement from secondary GBM is extremely rare [2,4].…”

The Role of Selected Chemokines and Their Receptors in the Development of Gliomas

“…The incidence of these metastases from primary intra-cranial malignant gliomas is estimated at less than 2% of all cases. Most frequent ENMs site include bones, lung, lymph nodes, liver, and neck [158].…”