Recurrent Glioblastoma: Where we stand

Abstract

Current first-line treatment regimens combine surgical resection and chemoradiation for Glioblastoma that provides a slight increase in overall survival. Age on its own should not be used as an exclusion criterion of glioblastoma multiforme (GBM) treatment, but performance should be factored heavily into the decision-making process for treatment planning. Despite aggressive initial treatment, most patients develop recurrent diseases which can be treated with re-resection, systemic treatment with targeted agents or cytotoxic chemotherapy, reirradiation, or radiosurgery. Research into novel therapies is investigating alternative temozolomide regimens, convection-enhanced delivery, immunotherapy, gene therapy, antiangiogenic agents, poly ADP ribose polymerase inhibitors, or cancer stem cell signaling pathways. Given the aggressive and resilient nature of GBM, continued efforts to better understand GBM pathophysiology are required to discover novel targets for future therapy.

Single‐institution retrospective review of patients with recurrent glioblastoma treated with bevacizumab in clinical practice

“…Because of the heterogeneous nature of glioblastoma, there is currently no standard treatment for patients with recurrent disease . Single‐agent bevacizumab or bevacizumab in combination with chemotherapy are accepted recurrence therapies in treatment practice guidelines .…”

“…Glioblastomas are the most common and most aggressive form of primary brain tumors in adults . Patients with glioblastoma have a very poor prognosis because of the high propensity for relapse, with reported median survival times for patients with recurrent disease of just 3 to 9 months . The angiogenic factor vascular endothelial growth factor (VEGF) is expressed at high levels in glioblastoma relative to other cancer types; thus, inhibitors of VEGF have been investigated for the treatment of glioblastoma…”

Validation of an established prognostic score after re-irradiation of recurrent glioma

“…Treatment of glioma recurrences remains a controversial topic and depends on the specialization of the treatment center [11,12]. Many centers favor Re-RT.…”

Spontaneous Glioblastoma Spheroid Infiltration of Early-Stage Cerebral Organoids Models Brain Tumor Invasion

“…1 Therapeutic intervention (including surgical debulking, radiotherapy, and chemotherapy) fails to effectively eliminate the entirety of the tumor and the rate of tumor recurrence remains high. 2 One aspect of GBM biology that poses a major therapeutic challenge is the diffuse GBM cell invasion into normal surrounding brain. [3][4][5] Emerging experimental and histological evidence indicates that GBM cell migration is accompanied by the expression of stem cell markers and can be predictive of patient outcomes.…”