Treatment options for glioblastoma

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  • Department of Interdisciplinary Oncology, Moffitt Cancer Center and Research Institute, Tampa, Florida
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✓ Following the seminal trial conducted by the European Organisation for Research and Treatment of Cancer (EORTC) and the National Cancer Institute of Canada (NCIC), concurrent temozolomide and radiotherapy has become the new standard of care for patients with newly diagnosed glioblastoma multiforme (GBM). Investigation of emerging therapies (which are now used as salvage therapy) such as small-molecule inhibitors (for example, epidermal growth factor receptor inhibitors) and convection-enhanced delivery (CED) of targeted toxins (for example, interleukin-13/pseudo-monas exotoxin) is likely to build on the EORTC/NCIC treatment platform and will, it is hoped, improve survival rates in patients with GBM. The majority of adjuvant Phase I and II trials being conducted by the brain tumor consortia are based on the EORTC/NCIC treatment platform and have added a targeted therapy in an effort to find a promising synergistic treatment. Furthermore, researchers in the consortia are continuing to explore treatments for recurrent GBM, not otherwise eligible for local therapies, such as CED. The treatments under study include novel cytotoxic chemotherapy as well as small-molecule inhibitors; these are being assessed in a variety of Phase I or II trials.

Abbreviations used in this paper:BCNU = 1,3-bis(2-chloroethyl)-1-nitrosourea; BTSG = Brain Tumor Study Group; CED = convection-enhanced delivery; EGFR = epidermal growth factor receptor; EORTC = European Organisation for Research and Treatment of Cancer; GBM = glioblastoma multiforme; HDAC = histone deacetylase; IL = interleukin; MGMT = O6 methylguanine–DNA methyltransferase; NCIC = National Cancer Institute of Canada; PI3K = phosphatidylinositol 3–kinase; poly-ICLC = polyinosinic–polycytidylic acid stabilized with polylysine and carboxymethylcellulose; RTOG = Radiation Therapy Oncology Group; SAHA = suberoylanilide hydroxamic acid; TMZ = temozolomide.

✓ Following the seminal trial conducted by the European Organisation for Research and Treatment of Cancer (EORTC) and the National Cancer Institute of Canada (NCIC), concurrent temozolomide and radiotherapy has become the new standard of care for patients with newly diagnosed glioblastoma multiforme (GBM). Investigation of emerging therapies (which are now used as salvage therapy) such as small-molecule inhibitors (for example, epidermal growth factor receptor inhibitors) and convection-enhanced delivery (CED) of targeted toxins (for example, interleukin-13/pseudo-monas exotoxin) is likely to build on the EORTC/NCIC treatment platform and will, it is hoped, improve survival rates in patients with GBM. The majority of adjuvant Phase I and II trials being conducted by the brain tumor consortia are based on the EORTC/NCIC treatment platform and have added a targeted therapy in an effort to find a promising synergistic treatment. Furthermore, researchers in the consortia are continuing to explore treatments for recurrent GBM, not otherwise eligible for local therapies, such as CED. The treatments under study include novel cytotoxic chemotherapy as well as small-molecule inhibitors; these are being assessed in a variety of Phase I or II trials.

Abbreviations used in this paper:BCNU = 1,3-bis(2-chloroethyl)-1-nitrosourea; BTSG = Brain Tumor Study Group; CED = convection-enhanced delivery; EGFR = epidermal growth factor receptor; EORTC = European Organisation for Research and Treatment of Cancer; GBM = glioblastoma multiforme; HDAC = histone deacetylase; IL = interleukin; MGMT = O6 methylguanine–DNA methyltransferase; NCIC = National Cancer Institute of Canada; PI3K = phosphatidylinositol 3–kinase; poly-ICLC = polyinosinic–polycytidylic acid stabilized with polylysine and carboxymethylcellulose; RTOG = Radiation Therapy Oncology Group; SAHA = suberoylanilide hydroxamic acid; TMZ = temozolomide.

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Contributor Notes

Address reprint requests to: Marc C. Chamberlain, M.D., Department of Interdisciplinary Oncology, Moffitt Cancer Center and Research Institute, 12902 Magnolia Avenue, Tampa, Florida 33612-0804. email: ChambeMC@moffitt.usf.edu.

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