Abstract
Glioblastoma multiforme (GBM) is an aggressive neoplasm of the brain that has commonly led to disappointing patient outcomes. Despite medical advancements and increasing research efforts, GBM studies reveal a stagnant survival rate at the global level with only sluggish improvement over time. Modern neuro-oncology research places a heavy emphasis on pharmacological therapies. Through a broad database search, we accumulated and synthesized the GBM-related neuroimmunocytological literature to create a comprehensive and contemporary review. Based on our findings, we discuss the recent neurocytological treatment strategies for GMB and the results of the studies. Regorafenib, paxalisib, and dianhydrogalactitol (VAL-083) are showing initial promise to decrease disease progression. VAL-083 is an alkylating agent that creates N7 methylation on DNA and has the ability to cross the blood-brain barrier (BBB). Selinexor, recombinant nonpathogenic polio-rhinovirus, and GBM-vaccine of autologous fibroblasts retrovirally transfected with TFG-IL4-Neo-TK vector have all also shown initial clinical benefit in terms of prolonging survival. Most trials observe modest improvement in outcomes with a positive safety profile. Nevertheless, the need for further studies is warranted, along with the trending of post-therapeutic biomarkers in order to better access future patient outcomes.
Highlights
BackgroundGrade 4 astrocytomas, commonly referred to as glioblastoma multiforme (GBM) or malignant gliomas, are aggressive and fast-growing primary brain neoplasms [1]
GBMs are the most common tumors derived from glial cell origins and account for roughly 47.7% of all primary neoplasms, making them the most common type of primary brain tumors [2]
Secondary GBMs are derived from lower-grade lesions and are often associated with isocitrate dehydrogenase-1 (IDH1) and O6-methylguanine-DNA methyltransferase (MGMT) mutations [4]
Summary
Grade 4 astrocytomas, commonly referred to as glioblastoma multiforme (GBM) or malignant gliomas, are aggressive and fast-growing primary brain neoplasms [1]. The enzyme-linked immune absorbent spot (ELISpot) assays showed systemic T-cell responses against an HLA-A2-restricted glioma-associated antigen (GAA) [31] Both participants showed clinical and radiological improvement with no adverse events of encephalitis; tumor recurrence did eventually manifest for both patients [31]. Okada et al [31], Autologous glioma cell vaccine showed clinical and radiological improvement yet both GBM patients in the study eventually had tumor recurrence. The results showed no statistical or observable difference between the two groups when assessing for quality of life, progression-free survival time, and overall survival time This showed that short-course radiotherapy can be a potential therapeutic option for elderly cases of GBM [34]. Current obstacles for GBM therapy include finding drugs that can penetrate the BBB, identifying specific tumor antigens, establishing therapeutic biomarkers, while augmenting vaccine therapies and preserving safety outcomes [36]
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