Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Aug 9;10(8):1927.
doi: 10.3390/biomedicines10081927.

Recurrent Glioblastoma Treatment: State of the Art and Future Perspectives in the Precision Medicine Era

Augusto Leone  1   2 , Antonio Colamaria  3 , Nicola Pio Fochi  4 , Matteo Sacco  3 , Matteo Landriscina  5 , Giovanni Parbonetti  6 , Matteo de Notaris  6 , Giulia Coppola  7 , Elena De Santis  8 , Guido Giordano  5 , Francesco Carbone  1   4
Affiliations
Review

Recurrent Glioblastoma Treatment: State of the Art and Future Perspectives in the Precision Medicine Era

Augusto Leone et al. Biomedicines. .

Abstract

Current treatment guidelines for the management of recurrent glioblastoma (rGBM) are far from definitive, and the prognosis remains dismal. Despite recent advancements in the pharmacological and surgical fields, numerous doubts persist concerning the optimal strategy that clinicians should adopt for patients who fail the first lines of treatment and present signs of progressive disease. With most recurrences being located within the margins of the previously resected lesion, a comprehensive molecular and genetic profiling of rGBM revealed substantial differences compared with newly diagnosed disease. In the present comprehensive review, we sought to examine the current treatment guidelines and the new perspectives that polarize the field of neuro-oncology, strictly focusing on progressive disease. For this purpose, updated PRISMA guidelines were followed to search for pivotal studies and clinical trials published in the last five years. A total of 125 articles discussing locoregional management, radiotherapy, chemotherapy, and immunotherapy strategies were included in our analysis, and salient findings were critically summarized. In addition, an in-depth description of the molecular profile of rGBM and its distinctive characteristics is provided. Finally, we integrate the above-mentioned evidence with the current guidelines published by international societies, including AANS/CNS, EANO, AIOM, and NCCN.

Keywords: brain tumor; chemotherapy; clinical trial; glioblastoma treatment; immunotherapy; molecular profile; recurrent glioblastoma; regorafenib; review; target therapy.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Current diagnostic and therapeutic management for rGBM.
Figure 2
Figure 2
Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol used for the present review.
See this image and copyright information in PMC

References

    1. Allemani C., Matsuda T., Di Carlo V., Harewood R., Matz M., Nikšić M., Bonaventure A., Valkov M., Johnson C.J., Estève J., et al. Global surveillance of trends in cancer survival 2000-14 (CONCORD-3): Analysis of individual records for 37,513,025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries. Lancet. 2018;391:1023–1075. doi: 10.1016/S0140-6736(17)33326-3. - DOI - PMC - PubMed
    1. Stupp R., Mason W.P., van den Bent M.J., Weller M., Fisher B., Taphoorn M.J.B., Belanger K., Brandes A.A., Marosi C., Bogdahn U., et al. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N. Engl. J. Med. 2005;352:987–996. doi: 10.1056/NEJMoa043330. - DOI - PubMed
    1. Stupp R., Hegi M.E., Mason W.P., van den Bent M.J., Taphoorn M.J.B., Janzer R.C., Ludwin S.K., Allgeier A., Fisher B., Belanger K., et al. Effects of radiotherapy with concomitant and adjuvant temozolomide versus radiotherapy alone on survival in glioblastoma in a randomised phase III study: 5-year analysis of the EORTC-NCIC trial. Lancet Oncol. 2009;10:459–466. doi: 10.1016/S1470-2045(09)70025-7. - DOI - PubMed
    1. National Comprehensive Cancer Network. [(accessed on 27 March 2022)]. Available online: https://www.nccn.org/
    1. De Bonis P., Anile C., Pompucci A., Fiorentino A., Balducci M., Chiesa S., Lauriola L., Maira G., Mangiola A. The influence of surgery on recurrence pattern of glioblastoma. Clin. Neurol. Neurosurg. 2013;115:37–43. doi: 10.1016/j.clineuro.2012.04.005. - DOI - PubMed

LinkOut - more resources