Glioblastoma Multiforme: An Evaluation of Existing and Alternative Treatment Modalities

Abstract

Glioblastoma Multiforme is one of the most aggressive brain tumours with very poor prognosis, low progression free survival rates and overall survival rates. This is predominantly due to the difficulty in transporting drugs across the blood brain barrier. Therefore, the need for more efficacious treatments is increasing. This paper explains the pathophysiology behind how signal transduction pathways leading from faults in the EGFRvIII and the IDH gene lead to gliomagenesis. It moves on to highlight and contrast conventional therapies such as Surgical Resection, Chemotherapy, Bevacizumab and Radiotherapy with novel, alternative therapies such as oncolytic virotherapy, photodynamic therapy and tumour treatment fields. A literature review was also conducted, wherein methods and results - specifically, the phase of trial, number of patients, treatment modality, median progression free survival, median overall survival and general comments- of five past research studies were explicated and interpreted for each GBM alternative treatment modalities - Photodynamic therapy, oncolytic virotherapy and tumour treatment fields. Each of the 5 clinical trial studies for each alternative treatment yielded varied results: The mean mOS (median Overall Survival) and mPFS (median Progression Free Survival) of patients were 15.3 months and 7.5 months for OV, 18.4 months and 16 months for PDT, and 19.9 months and 6 months for TTF respectively. This paper intends to provide an insight into the future of Glioblastoma Multiforme treatment to further improve its diagnosis, prognosis and treatment.