Date of Conferral

2021

Degree

Ph.D.

School

Public Health

Advisor

Harold R. Griffin

Abstract

Glioblastoma (GBM) is an aggressive form of brain cancer that has a high recurrence rate and very poor prognosis. The prognostic value of various molecular markers (e.g., IDH 1 mutation, MGMT promoter methylation, etc.) and clinical factors (e.g., age, KPS, surgery and chemotherapy) has been studied in GBM after initial diagnosis but not as extensively in the recurrent GBM. Utilizing a retrospective cohort design, based on quantitative data collected through medical chart reviews, and the conceptual framework of outcomes research in oncology, this study evaluated the prognostic value of IDH-1 mutation in recurrent GBM in the context of key predictor variables of age, MGMT promoter methylation, KPS, and surgery and chemotherapy at recurrence. The study specifically evaluated if there was a significant difference in overall survival and progression free survival between rGBM patients with and without IDH-1 mutation and if selected molecular and clinical covariates affected these outcomes. The results of this study indicated, albeit with its limitations, that IDH-1 mutation was not a prognostic factor in recurrent GBM. The prognostic value of IDH-1 mutation from initial diagnosis in this study was inconclusive, consistent with previous reports. The results of this study also indicated that although methylated MGMT promoter was a strong prognostic factor from initial diagnosis as previously reported, it was not a prognostic factor in recurrent GBM. Overall, the results of this study suggest that the prognosis and treatment of GBM may need to be considered differently at initial diagnosis and following disease recurrence. It is anticipated that the results of this study will bring about a positive social change by affecting both patient treatment and health care practice in recurrent GBM.

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