Highlighted Advances in Therapies for Difficult-To-Treat Brain Tumours Such as Glioblastoma.
Nuno CruzManuel Herculano-CarvalhoDiogo RoqueCláudia C FariaRita CascãoHugo Alexandre FerreiraCatarina Pinto ReisNuno MatelaPublished in: Pharmaceutics (2023)
Glioblastoma multiforme (GBM) remains a challenging disease, as it is the most common and deadly brain tumour in adults and has no curative solution and an overall short survival time. This incurability and short survival time means that, despite its rarity (average incidence of 3.2 per 100,000 persons), there has been an increased effort to try to treat this disease. Standard of care in newly diagnosed glioblastoma is maximal tumour resection followed by initial concomitant radiotherapy and temozolomide (TMZ) and then further chemotherapy with TMZ. Imaging techniques are key not only to diagnose the extent of the affected tissue but also for surgery planning and even for intraoperative use. Eligible patients may combine TMZ with tumour treating fields (TTF) therapy, which delivers low-intensity and intermediate-frequency electric fields to arrest tumour growth. Nonetheless, the blood-brain barrier (BBB) and systemic side effects are obstacles to successful chemotherapy in GBM; thus, more targeted, custom therapies such as immunotherapy and nanotechnological drug delivery systems have been undergoing research with varying degrees of success. This review proposes an overview of the pathophysiology, possible treatments, and the most (not all) representative examples of the latest advancements.
Keyphrases
- newly diagnosed
- locally advanced
- prognostic factors
- resting state
- healthcare
- ejection fraction
- white matter
- early stage
- risk factors
- minimally invasive
- end stage renal disease
- radiation therapy
- high resolution
- blood brain barrier
- quality improvement
- cross sectional
- palliative care
- patients undergoing
- coronary artery bypass
- radiation induced
- cancer therapy
- cerebral ischemia
- mesenchymal stem cells
- subarachnoid hemorrhage
- drug delivery
- chronic pain
- patient reported outcomes
- body composition
- percutaneous coronary intervention
- acute coronary syndrome
- high intensity
- chemotherapy induced
- patient reported