Conclusions

This real-world evidence study shows that adherence to the frontline Stupp regimen confers a substantial survival benefit (24 vs. 11 months; p = 0.023) among patients with hemispheric GB treated within Uruguay’s public health system, with an overall cohort median survival of 17 months. These findings support the success of universal TMZ access policies. However, a persistent therapeutic ceiling remains, and the absence of historical molecular profiling highlights a critical regional diagnostic gap that should be addressed.

As the therapeutic landscape shifts toward high-cost immunotherapies and CAR-T platforms, regional health systems should use this historical baseline to inform agile, equity-driven funding policies and international pricing negotiations. Securing equitable access to advanced biotechnology will require moving beyond individual administrative allocation models toward structured, regional health policy frameworks.