Objective: Glioblastoma (GBM) is the most common primary malignant brain tumor and is characterized by significant intratumoral heterogeneity. This study aimed to investigate the clinical and genomic landscapes of GBM across diverse ethnic populations to identify potential prognostic markers. Methods: Leveraging The Cancer Imaging Archive (TCIA) and bioinformatics modeling, White, African, and Asian American cohorts were analyzed. Patients were stratified according to the 2021 WHO classification of central nervous system (CNS) tumors. Population-specific genomic drivers and phenotypic markers were evaluated for their impact on outcomes. Survival rates across age, sex, and ethnicity were estimated using the Kaplan-Meier method and Cox proportional hazards models. Results: Incidence was highest among White American males aged 50–60 (n = 105, 34%) compared with females in the same age group (n = 48, 24%). Asian Americans exhibited a lower incidence rate (0.46-fold) compared to White individuals. In the adjusted model, Asian American ethnicity showed a trend toward a different survival outcome (HR 0.464; 95% CI 0.206–1.047; p = 0.064). The co-occurrence of chromosome 7 gains and chromosome 10 losses (+7/−10) was associated with significantly lower survival rates compared to those without combined alterations (HR 0.798; 95% CI 0.647–0.984; p = 0.035). Conclusions: Epidemiological evidence-based medicine shows that the chromosome +7/−10 genotype predicts poor survival, particularly in high-risk White (Caucasian) males. Its lower prevalence in African and Asian American cohorts suggests the presence of distinct ancestry-specific oncogenic drivers. Integrating ethnic stratification into clinical frameworks is essential for improving biomarker-informed diagnostics and ensuring equity in personalized GBM treatment strategies based on ancestry-informative genetic markers.
Chiu et al. (Thu,) studied this question.