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For decades, scientists have recognized that more males get cancer and die of the disease than females. This is true for many types of cancer, including the deadly brain tumor glioblastoma. Now, a team of researchers led by Washington University School of Medicine in St. Louis has identified distinct molecular signatures of glioblastoma in men and women that help explain such underlying disparities in patients’ response to treatment and survival.The research suggests that tailoring treatments to men and women with glioblastoma based on the molecular subtypes of their tumors may improve survival for all patients.
The findings are published Jan. 2 in Science Translational Medicine.
“It is our expectation that this study could have an immediate impact on the care of patients with glioblastoma and further research, as the findings indicate we should be stratifying male and female glioblastoma into risk groups and evaluating the effectiveness of treatment in a sex-specific manner,” said Joshua B. Rubin, MD, Ph.D., a Washington University professor of pediatrics and of neuroscience and the study’s co-senior author. “The biology of sex differences and its applications in medicine are highly relevant but almost always ignored aspects of personalized treatments.”
Glioblastoma is the most common malignant brain tumor and kills about half of patients within 14 months of diagnosis. It is diagnosed nearly twice as often in males, compared with females.
The tumor is most often diagnosed in people over age 50, and standard treatment is aggressive—surgery, followed by chemotherapy and radiation. However, stubborn stem cells often survive and continue to divide, producing new tumor cells to replace the ones killed by treatment. Most tumors recur within six months.
Studying adults with glioblastoma, the researchers found that standard treatment for glioblastoma is more effective in women than men.
To help understand such sex differences in treatment response, the researchers, including Kristin R. Swanson, Ph.D., a mathematical oncologist at the Mayo Clinic, measured tumor growth velocity in standard MRI scans.
“Basically, you can look at tumor growth velocity while patients are undergoing treatment and derive a value for how fast their tumors are growing,” said Rubin, who also is co-founder and co-director of the Pediatric Neuro-Oncology Program at St. Louis Children’s Hospital, where he treats patients. “This gives you an opportunity to think more deeply about whether the drug you’re giving a patient is actually helping.
