Glioblastoma in Adults: Current Management and Future Directions

A special issue of Current Oncology (ISSN 1718-7729). This special issue belongs to the section "Neuro-Oncology".

Deadline for manuscript submissions: closed (31 October 2023) | Viewed by 5335

Special Issue Editors


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Guest Editor
Department of Neurosurgery, Hospital La Timone, Aix Marseille Univ, APHM, Marseille, France
Interests: neuro-oncology; brain surgery; skull base; intracranial aneurysm; endoscopic neurosurgery

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Guest Editor
Department of Neurosurgery, Hospital La Timone, Aix Marseille Univ, APHM, Marseille, France
Interests: glioma; neuro-oncology; brain surgery; neurocognition; brain plasticity; neuropsychology

Special Issue Information

Dear Colleagues,

As you know, glioma is the most common primary tumor of the central nervous system, and is characterized by rapid growth and aggressiveness; glioblastoma is one of the most dreaded brain tumors. There has been a commitment to drug development and new treatments for glioma, but progress has been limited, and the prognosis for patients with GBM remains poor. Inherent or acquired resistance to existing therapies, regional and heterogeneous blood glioma barriers, and the number of stem-cell-like cells within glioblastomas are challenges that are being actively addressed. These new approaches need to be summarized, especially regarding fundamental oncology approaches, and in the light of the new WHO brain tumor classification of 2021.

Dr. Thomas Graillon
Dr. Sebastien Boissonneau
Guest Editors

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Keywords

  • glioblastoma
  • innovation
  • tumor metabolism
  • neuro-oncology
  • WHO classification 2021

Published Papers (3 papers)

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Research

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11 pages, 423 KiB  
Article
Treatment Patterns and Outcomes of Patients with Grade 4 Glioma Treated with Radiation during the COVID-19 Pandemic
by Manik Chahal, Ghufran Aljawi, Rebecca Harrison, Alan Nichol and Brian Thiessen
Curr. Oncol. 2023, 30(3), 3091-3101; https://doi.org/10.3390/curroncol30030234 - 07 Mar 2023
Cited by 1 | Viewed by 1584
Abstract
During the first year of the COVID-19 pandemic there was a global disruption in the provision of healthcare. Grade 4 gliomas are rapidly progressive tumors, and these patients are at risk of poorer outcomes due to delays in diagnosis or treatment. We retrospectively [...] Read more.
During the first year of the COVID-19 pandemic there was a global disruption in the provision of healthcare. Grade 4 gliomas are rapidly progressive tumors, and these patients are at risk of poorer outcomes due to delays in diagnosis or treatment. We retrospectively evaluated the impact of the pandemic on treatment patterns and outcomes of patients with grade 4 gliomas in British Columbia. We identified a cohort of 85 patients treated with radiotherapy between March 2020–2021 (COVID era) and compared baseline characteristics, treatments, and outcomes with a control cohort of 79 patients treated between March 2018–2019 (pre-COVID era). There were fewer patients treated with radiotherapy over age 65 in the COVID era compared to the pre-COVID era (p = 0.037). Significantly more patients were managed with biopsy relative to partial or gross total resection during the COVID era compared to the pre-COVID era (p = 0.04), but there were no other significant differences in time to assessment, time to treatment, or administration of adjuvant therapy. There was no difference in overall survival between eras (p = 0.189). In this assessment of outcomes of grade 4 gliomas during the pandemic, we found that despite less aggressive surgical intervention during the COVID era, outcomes were similar between eras. Full article
(This article belongs to the Special Issue Glioblastoma in Adults: Current Management and Future Directions)
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Review

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13 pages, 1555 KiB  
Review
Proteasome Inhibitors against Glioblastoma—Overview of Molecular Mechanisms of Cytotoxicity, Progress in Clinical Trials, and Perspective for Use in Personalized Medicine
by Agata Gozdz
Curr. Oncol. 2023, 30(11), 9676-9688; https://doi.org/10.3390/curroncol30110702 - 02 Nov 2023
Cited by 1 | Viewed by 1460
Abstract
Proteasome inhibitors are moieties targeting the proteolytic activity of a proteasome, with demonstrated efficacy in certain hematological malignancies and candidate drugs in other types of cancer, including glioblastoma (GBM). They disturb the levels of proteasome-regulated proteins and lead to the cell cycle inhibition [...] Read more.
Proteasome inhibitors are moieties targeting the proteolytic activity of a proteasome, with demonstrated efficacy in certain hematological malignancies and candidate drugs in other types of cancer, including glioblastoma (GBM). They disturb the levels of proteasome-regulated proteins and lead to the cell cycle inhibition and apoptosis of GBM cells. The accumulation of cell cycle inhibitors p21 and p27, and decreased levels of prosurvival molecules NFKB, survivin, and MGMT, underlie proteasome inhibitors’ cytotoxicity when used alone or in combination with the anti-GBM cytostatic drug temozolomide (TMZ). The evidence gathered in preclinical studies substantiated the design of clinical trials that employed the two most promising proteasome inhibitors, bortezomib and marizomib. The drug safety profile, maximum tolerated dose, and interaction with other drugs were initially evaluated, mainly in recurrent GBM patients. A phase III study on newly diagnosed GBM patients who received marizomib as an adjuvant to the Stupp protocol was designed and completed in 2021, with the Stupp protocol receiving patients as a parallel control arm. The data from this phase III study indicate that marizomib does not improve the PFS and OS of GBM patients; however, further analysis of the genetic and epigenetic background of each patient tumor may shed some light on the sensitivity of individual patients to proteasome inhibition. The mutational and epigenetic makeup of GBM cells, like genetic alterations to TP53 and PTEN, or MGMT promoter methylation levels may actually determine the response to proteasome inhibition. Full article
(This article belongs to the Special Issue Glioblastoma in Adults: Current Management and Future Directions)
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18 pages, 11408 KiB  
Review
Diagnostic Approaches to Adult-Type Diffuse Glial Tumors: Comparative Literature and Clinical Practice Study
by Vincentas Veikutis, Mindaugas Brazdziunas, Evaldas Keleras, Algidas Basevicius, Andrei Grib, Darijus Skaudickas and Saulius Lukosevicius
Curr. Oncol. 2023, 30(9), 7818-7835; https://doi.org/10.3390/curroncol30090568 - 24 Aug 2023
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Abstract
Gliomas are the most frequent intrinsic central nervous system tumors. The new 2021 WHO Classification of Central Nervous System Tumors brought significant changes into the classification of gliomas, that underline the role of molecular diagnostics, with the adult-type diffuse glial tumors now identified [...] Read more.
Gliomas are the most frequent intrinsic central nervous system tumors. The new 2021 WHO Classification of Central Nervous System Tumors brought significant changes into the classification of gliomas, that underline the role of molecular diagnostics, with the adult-type diffuse glial tumors now identified primarily by their biomarkers rather than histology. The status of the isocitrate dehydrogenase (IDH) 1 or 2 describes tumors at their molecular level and together with the presence or absence of 1p/19q codeletion are the most important biomarkers used for the classification of adult-type diffuse glial tumors. In recent years terminology has also changed. IDH-mutant, as previously known, is diagnostically used as astrocytoma and IDH-wildtype is used as glioblastoma. A comprehensive understanding of these tumors not only gives patients a more proper treatment and better prognosis but also highlights new difficulties. MR imaging is of the utmost importance for diagnosing and supervising the response to treatment. By monitoring the tumor on followup exams better results can be achieved. Correlations are seen between tumor diagnostic and clinical manifestation and surgical administration, followup care, oncologic treatment, and outcomes. Minimal resection site use of functional imaging (fMRI) and diffusion tensor imaging (DTI) have become indispensable tools in invasive treatment. Perfusion imaging provides insightful information about the vascularity of the tumor, spectroscopy shows metabolic activity, and nuclear medicine imaging displays tumor metabolism. To accommodate better treatment the differentiation of pseudoprogression, pseudoresponse, or radiation necrosis is needed. In this report, we present a literature review of diagnostics of gliomas, the differences in their imaging features, and our radiology’s departments accumulated experience concerning gliomas. Full article
(This article belongs to the Special Issue Glioblastoma in Adults: Current Management and Future Directions)
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