Diagnosis, Pathogenesis, Treatment and Prognosis of Glioblastoma

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Neurobiology and Clinical Neuroscience".

Deadline for manuscript submissions: 31 July 2024 | Viewed by 542

Special Issue Editor


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Guest Editor
Clinical Neurosciences and Mental Health Department, Faculty of Medicine, University of Oporto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
Interests: Neuro-oncologia, Cirurgia de tumores cerebrais com o doente acordado e mapeamento cerebral, Cirurgia de tumores cerebrais com imunofluorescência, Cirurgia de gliomas de baixo grau, Cirurgia da epilepsia, Cirurgia Intracraniana, Patologia da Coluna Vertebral.

Special Issue Information

Dear Colleagues,

Are the genetic changes already adequately known to determine the biological behavior of glioblastomas? Will there be immunotherapy and effective directed treatments for glioblastomas? What is the best treatment for elderly patients and for patients with multicentric lesions? What is the role of reirradiation? What is the experience so far with LITT and TTF?

Although there have been recent advances in molecular characterization and treatments, the prognostic remains dismissive, with most patients dying within 15–18 months. In the USA, the 5-year survival rate has been reported as 6.8%.

Despite the longer genetic and molecular assessment of glioblastoma, the standard treatment is still a combination of surgery, radiotherapy and chemotherapy; thus, significant ongoing challenges remain for the treatment.

The relationship of genetic and molecular changes with image findings may allow different diagnostic approaches.

Understanding glioblastoma and its pathogenesis is critical for researching new forms of treatment as well understanding its resistance mechanisms and escape from immune surveillance.

In addition to immunotherapy and target therapies, non-pharmacological options such as TTFs and LITT have emerged as viable treatment options, although with currently uncertain results.

Here, we will try to provide answers to some of these questions, and we will certainly raise other questions that will remain unanswered.

Prof. Dr. Paulo Linhares
Guest Editor

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Keywords

  • glioblastoma
  • immunotherapy
  • molecular subtype
  • radiotherapy
  • molecular therapy
  • emerging treatment
  • drug resistance
  • MRI
  • immune surveillance

Published Papers (1 paper)

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Research

12 pages, 1405 KiB  
Article
Sequential Evaluation of Hematology Markers as a Prognostic Factor in Glioblastoma Patients
by João Meira Gonçalves, Bruno Carvalho, Rui Tuna, Patricia Polónia and Paulo Linhares
Biomedicines 2024, 12(5), 1067; https://doi.org/10.3390/biomedicines12051067 - 12 May 2024
Viewed by 364
Abstract
In our study, we investigated the prognostic significance of hematological markers—NLR (Neutrophil-to-Lymphocyte Ratio), PLR (Platelet-to-Lymphocyte Ratio), and RDW-CV (Red Blood Cell Distribution Width—Coefficient of Variation)—in 117 glioblastoma patients. The data collected from January 2016 to December 2018 included demographics, clinical scores, and treatment [...] Read more.
In our study, we investigated the prognostic significance of hematological markers—NLR (Neutrophil-to-Lymphocyte Ratio), PLR (Platelet-to-Lymphocyte Ratio), and RDW-CV (Red Blood Cell Distribution Width—Coefficient of Variation)—in 117 glioblastoma patients. The data collected from January 2016 to December 2018 included demographics, clinical scores, and treatment regimens. Unlike previous research, which often examined these markers solely before surgery, our unique approach analyzed them at multiple stages: preoperative, postoperative, and before adjuvant therapies. We correlated these markers with the overall survival (OS) and progression-free survival (PFS) using statistical tools, including ANOVA, Cox regression, and Kaplan–Meier survival analyses, employing SPSS version 29.0. Our findings revealed notable variations in the NLR, PLR, and RDW-CV across different treatment stages. The NLR and PLR decreased after surgery, with some stabilization post-STUPP phase (NLR: p = 0.007, η2p = 0.06; PLR: p = 0.001, η2p = 0.23), while the RDW-CV increased post-surgery and during subsequent treatments (RDW-CV: p < 0.001, η2p = 0.67). Importantly, we observed significant differences between the preoperative phase and other treatment phases. Additionally, a higher NLR and RDW-CV at the second-line treatment and disease progression were associated with an increased risk of death (NLR at 2nd line: HR = 1.03, p = 0.029; RDW-CV at progression: HR = 1.14, p = 0.004). We proposed specific marker cut-offs that demonstrated significant associations with survival outcomes when applied to Kaplan–Meier survival curves (NLR at 2nd line < 5: p < 0.017; RDW-CV at progression < 15: p = 0.007). An elevated NLR and RDW-CV at later treatment stages correlated with poorer OS and PFS. No significant preoperative differences were detected. These biomarkers may serve as non-invasive tools for glioblastoma management. Full article
(This article belongs to the Special Issue Diagnosis, Pathogenesis, Treatment and Prognosis of Glioblastoma)
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