Glioblastoma Treatment and Challenges
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Standard treatment of patients newly diagnosed with glioblastoma includes surgery to remove as much possible the tumor, radiation therapy, and chemotherapy. Tumor-Treating Fields, a device generating electrical fields to slow tumor growth received FDA-approval in 2015.
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Corticosteroids are used to alleviate cerebral edema (brain swelling) and antiepileptic drugs to control seizures.
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Despite a multimodal treatment, glioblastoma has a two-year survival rate of only 17% and tumor recurrence is inevitable.
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Some Challenges in Glioblastoma Treatment:
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Surgery limitations due to the tumor location. Despite maximal surgical resection, tumor cells invade surrounding normal brain tissue.
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Complex clinical management of elderly patients, neurological deficits, treatment side effects.
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Alterations of genes in the tumor and its microenvironment sustain proliferation, spreading, resistance to cell death, evasion from the immune system, resistance to treatment and tumor recurrence.
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Glioblastoma stem cells resist to chemotherapy and radiotherapy and initiate a new tumor.
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Molecular heterogeneity within the same tumor and between patients challenge the concept of one-standard treatment for all.
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The Blood-Brain Barrier protects the brain, which limits access of drugs to the tumor and decreases treatment efficacy.