Novel Treatment Strategies for Glioblastoma

Abstract

Glioblastoma (GBM) is the most common primary central nervous system tumor in adults. It is a highly invasive disease, making it difficult to achieve a complete surgical resection, resulting in poor prognosis with a median survival of 12–15 months after diagnosis, and less than 5% of patients survive more than 5 years. Surgical, instrument technology, diagnostic and radio/chemotherapeutic strategies have slowly evolved over time, but this has not translated into significant increases in patient survival. The current standard of care for GBM patients involving surgery, radiotherapy, and concomitant chemotherapy temozolomide (known as the Stupp protocol), has only provided a modest increase of 2.5 months in median survival, since the landmark publication in 2005. There has been considerable effort in recent years to increase our knowledge of the molecular landscape of GBM through advances in technology such as next-generation sequencing, which has led to the stratification of the disease into several genetic subtypes. Current treatments are far from satisfactory, and studies investigating acquired/inherent resistance to current therapies, restricted drug delivery, inter/intra-tumoral heterogeneity, drug repurposing and a tumor immune-evasive environment have been the focus of intense research over recent years. While the clinical advancement of GBM therapeutics has seen limited progression compared to other cancers, developments in novel treatment strategies that are being investigated are displaying encouraging signs for combating this disease. This aim of this editorial is to provide a brief overview of a select number of these novel therapeutic approaches.

Glioma glycolipid metabolism: MSI2–SNORD12B–FIP1L1–ZBTB4 feedback loop as a potential treatment target

“…The median survival time of GBM patients is approximately 12-15 months. 2 Reprogramming of energy metabolism is an important indicator of malignant tumors. [3][4][5] Abnormal energy metabolism has also been reported in GBM and includes enhanced aerobic glycolysis and lipid synthesis to provide energy and raw materials to the highly proliferating cells.…”

New Insights into the Multifaceted Role of Myeloid-Derived Suppressor Cells (MDSCs) in High-Grade Gliomas: From Metabolic Reprograming, Immunosuppression, and Therapeutic Resistance to Current Strategies for Targeting MDSCs

“…Malignant gliomas that originate from glial, neural stem cells and astrocytes are the most aggressive tumors of the central nervous system (CNS) and spinal cord with a median survival of less than 12–15 months [ 1 ]. The current standard of care therapies such as surgery, radiotherapy, and chemotherapy have had only limited success in increasing the lifespan of glioma patients [ 2 ].…”

Nomograms individually predict the overall survival and cancer-specific survival of adult patients with hemispheres lower-grade gliomas: A SEER-Based Study

“…A safe maximal excision of the glioma without neurological functioning de ciency was the main therapeutic strategy as strong evidence has demonstrated that more extensive resections can prolong patients' survival time [6,27,28]. Both the OS and CSS nomograms in the study showed that surgery was a strong individual predictive factor for LGGs and gross total resection (GTR) is recommended under permissive conditions.…”