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CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol 2015; 36(04): 229-237
DOI: 10.4103/0971-5851.171543
REVIEW ARTICLE

Therapeutic approach beyond conventional temozolomide for newly diagnosed glioblastoma: Review of the present evidence and future direction

Supriya Mallick
Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India
,
Ajeet Kumar Gandhi
Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India
,
Goura Kishor Rath
Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi; National Cancer Institute, (2nd Campus) All India Institute of Medical Sciences, Jhajjar, Haryana, India
› Author Affiliations Financial support and sponsorship Nil.
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Abstract

Glioblastoma multiforme (GBM) is the most aggressive form of primary brain tumor. Maximal safe surgical resection followed by adjuvant partial brain radiation with concurrent and adjuvant temozolomide (TMZ) (oral alkylating agent) is the standard of care. Five years survival in TMZ treated patient reaches 9.8%. We aimed to summarize the changes in the management of GBM beyond conventional temozolomide based adjuvant treatment. We searched the PUBMED with the following key words: Glioblastoma, phase III trial, Phase II trial, adjuvant treatment in GBM. Clinical research has found a wide range of molecular aberrations in GBM and attempts are being made to further improve survival with the addition of different classes of drugs. Angiogenesis inhibitors, oncolytic vaccines, dose dense TMZ, and anti-epidermal growth factor receptor monoclonal antibody in phase III trials have failed to improve survival. Recent studies have also shown that the management strategies might be different and needs to be customized as per the age of patients such as pediatric and elderly patients. In addition, treatments should be personalized depending on the molecular aberrations. We reviewed all published phase III trials for newly diagnosed GBM as well as also looked into possible future directions in this review. Limited progress has happed beyond conventional TMZ in the adjuvant treatment of GBM. Newer insights are emerging about treatment intensification and introduction of newer molecular targeted drugs with more information about molecular aberrations.

Keywords

Bevacizumab - glioblastoma - hypofractionated radiotherapy - temozolomide - vaccine


Publication History

Article published online:
12 July 2021

© 2015. Indian Society of Medical and Paediatric Oncology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

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