Abstract
The different drugs and medical devices, which are commercialized or under industrial development for glioblastoma treatment, are reviewed. Their different modes of action are analyzed with a distinction being made between the effects of radiation, the targeting of specific parts of glioma cells, and immunotherapy. Most of them are still at a too early stage of development to firmly conclude about their efficacy. Optune, which triggers antitumor activity by blocking the mitosis of glioma cells under the application of an alternating electric field, seems to be the only recently developed therapy with some efficacy reported on a large number of GBM patients. The need for early GBM diagnosis is emphasized since it could enable the treatment of GBM tumors of small sizes, possibly easier to eradicate than larger tumors. Ways to improve clinical protocols by strengthening preclinical studies using of a broader range of different animal and tumor models are also underlined. Issues related with efficient drug delivery and crossing of blood brain barrier are discussed. Finally societal and economic aspects are described with a presentation of the orphan drug status that can accelerate the development of GBM therapies, patents protecting various GBM treatments, the different actors tackling GBM disease, the cost of GBM treatments, GBM market figures, and a financial analysis of the different companies involved in the development of GBM therapies.
Highlights
Glioblastoma multiform (GBM) is a malignant tumor originating from glial cells
I review the different drugs and medical devices, which are under development or commercialized by companies, have been pre-clinically or clinically tested, most frequently involve medical teams, and either result in direct GBM cell destruction or are part of a GBM treatment protocol, e.g., through GBM imaging
GBM treatments that are under development or commercialized include:
Summary
Glioblastoma multiform (GBM) is a malignant tumor originating from glial cells. It is the most frequent brain tumor, representing 30% of all central nervous system tumors (CNST), 45% of malignant CNST and 80% of primary malignant CNST. GBM current standard of care (SOC) includes maximal safe resection followed by radiotherapy and chemotherapy using temozolomide (TMZ) Such treatment hardly increases patient survival and leads to a median overall survival (OS) of only 12–18 months following diagnosis (Stupp et al, 2005; Wen and Kesari, 2008). Full tumor resection would require very precise imaging and surgical tools to enable the visualization and removal of all GBM infiltrating cells. I review the different drugs and medical devices, which are under development or commercialized by companies, have been pre-clinically or clinically tested, most frequently involve medical teams, and either result in direct GBM cell destruction or are part of a GBM treatment protocol, e.g., through GBM imaging. Surgery is feasible in ∼60% of all GBM patients (Stark et al, 2012) For these patients, it represents the initial treatment and usually consists in maximal safe surgical resection. Surgical methods and associated imaging techniques, which are under development to improve the efficacy of surgery and reduce its side effects, are described below
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