Glioblastoma Treatments: Where Do We Stand?
Glioblastoma, also known as glioblastoma multiform, is the most common primary
brain tumor in adults. It remains an unmet need in oncology. To gauge the difficulties
encountered in devising lines of treatment for it, it is helpful to understand the
morphology of brain cancers and their different biological types, and their associated
risks. It is likewise important to grasp how a diagnosis of a suspected such tumor
could be arrived at in both the initial and the very often recurring case, and what are
the prognoses in these several instances. I will also detail the various treatments that
have been devised so far for primary tumors and their metastases in both cases of
monotherapies or combination therapies, and for recurring tumors after treatment.
For each such therapy, the treatment results obtained in clinical trials and other
reported practices will also be discussed and summarized. At the outset, however,
it must be recalled that the use of cytotoxic drugs (chemotherapy) is essentially an
educated trial-and-error approach with one approved drug or a combination of a
number of such drugs. It does not rely on the deep understanding of the tumor
biology nor does it consider the braiding of both normal and cancerous cells that is
embedded in our genome. As a result, it has historically provided little durable benefit
with tumors recurring within several months, even in the case of more accessible
tumors located outside the brain; for brain tumors, the access is even more difficult
because of the presence of the brain protective barriers, chief among these being the
blood brain barrier, compounding the difficulties. More effective therapies involving
other options are required either in isolation or more likely in combination. Of these
other options, the following will be considered at some length: surgery, conformal
radiotherapy, boron neutron therapy, intensity modulated proton beam therapy, antiangiogenic
therapy, alternating electric field therapy without neglecting palliative
therapies. Research conducted in these and other options is also reviewed to include
microRNA, immunotherapy, adjuvant therapy, gene therapy, stem cell therapy, and
intra-nasal drug delivery.
For full article click here==========> Article