Glioblastoma multiforme (GBM) is the most common primary malignant tumor of the brain with a dismal prognosis. Approximately 30.9% of these primary brain tumors are malignant, with GBM being the most commonly identified malignant histology with an annual-age adjusted incidence rate of 14.7%. The annual age-adjusted incidence for GBM among persons age above 40 years is 3.21 per 100,000 population. Further, lack of effective therapies lead to inevitable relapse and approximately 70% of the patients die with in first 2 years of diagnosis. Of all the malignant brain tumors, GBM has the worst prognosis with five-year survival of 5.6%.

In majority of cases, treatment recommendations are based on the patient’s current performance status, molecular profile and sub-type of GBM. Yet, patients may refuse all or parts of the recommended treatment. In malignancies including head and neck, lung, and pancreatic cancers – subsets that refused treatments have been identified to be greater than 80 years old, of African American descent, carrying non-private insurance, and presence of increased number of comorbidities as predictors of refusing recommended therapies. Using a national database for patients with newly diagnosed GBM, this study is focusing on assessing the patterns of denying recommended treatments and its impact on the outcomes.