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Recurrent Glioblastoma

Treatment

What are the available treatment options for glioblastoma?

Treatment plan for glioblastoma involves a multimodal approach.

Treatment plan for glioblastoma involves a multimodal approach – in other words, a combination of approaches.

I. Surgery

Surgery is invariably the first step of treatment of glioblastoma. Surgical procedure helps in diagnosis, in relieving pressure on the brain and to safely remove as much tumour as possible. Surgery is performed very carefully so as to not disrupt important regions of the brain that control many motor activities.

II. Chemotherapy & Radiation

Since the publication of a landmark clinical trial in 2005, the standard-of-care for GBM has been maximal safe surgical removal of cancer, followed by radiotherapy and chemotherapy with temozolomide (TMZ), an oral alkylating chemotherapy agent.

III. Targeted therapy

Bevacizumab, a monoclonal antibody, is the only targeted therapy approved for the treatment of recurrent glioblastoma so far. Bevacizumab works by binding to a protein called vascular endothelial growth factor (VEGF), thereby blocking cell proliferation and new blood vessel formation and the site of tumour. Specifically in case of GBM, progression free survival due to bevacizumab could be more due to the drug’s ability to decrease blood-brain barrier permeability when compared to an anti-tumour effect.

Abbreviations

CT/CAT scan: Computed Tomography scan GBM: Glioblastoma multiforme MRI scan: Magnetic resonance imaging scan MRS: Magnetic resonance spectroscopy PET scan: Positron emission tomography scan rGBM: Recurrent glioblastoma multiforme TMZ: temozolomide VEGF: Vascular Endothelial Growth Factor

References

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