Recurrent Glioblastoma Treatment: State of the Art and Future Perspectives in the Precision Medicine Era

Current treatment guidelines for the management of recurrent glioblastoma (rGBM) are far from definitive, and the prognosis remains dismal. Despite recent advancements in the pharmacological and surgical fields, numerous doubts persist concerning the optimal strategy that clinicians should adopt for...

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Main Authors: Augusto Leone, Antonio Colamaria, Nicola Pio Fochi, Matteo Sacco, Matteo Landriscina, Giovanni Parbonetti, Matteo de Notaris, Giulia Coppola, Elena De Santis, Guido Giordano, Francesco Carbone
Format: Article
Language:English
Published: MDPI AG 2022-08-01
Series:Biomedicines
Subjects:
Online Access:https://www.mdpi.com/2227-9059/10/8/1927
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author Augusto Leone
Antonio Colamaria
Nicola Pio Fochi
Matteo Sacco
Matteo Landriscina
Giovanni Parbonetti
Matteo de Notaris
Giulia Coppola
Elena De Santis
Guido Giordano
Francesco Carbone
author_facet Augusto Leone
Antonio Colamaria
Nicola Pio Fochi
Matteo Sacco
Matteo Landriscina
Giovanni Parbonetti
Matteo de Notaris
Giulia Coppola
Elena De Santis
Guido Giordano
Francesco Carbone
author_sort Augusto Leone
collection DOAJ
description Current treatment guidelines for the management of recurrent glioblastoma (rGBM) are far from definitive, and the prognosis remains dismal. Despite recent advancements in the pharmacological and surgical fields, numerous doubts persist concerning the optimal strategy that clinicians should adopt for patients who fail the first lines of treatment and present signs of progressive disease. With most recurrences being located within the margins of the previously resected lesion, a comprehensive molecular and genetic profiling of rGBM revealed substantial differences compared with newly diagnosed disease. In the present comprehensive review, we sought to examine the current treatment guidelines and the new perspectives that polarize the field of neuro-oncology, strictly focusing on progressive disease. For this purpose, updated PRISMA guidelines were followed to search for pivotal studies and clinical trials published in the last five years. A total of 125 articles discussing locoregional management, radiotherapy, chemotherapy, and immunotherapy strategies were included in our analysis, and salient findings were critically summarized. In addition, an in-depth description of the molecular profile of rGBM and its distinctive characteristics is provided. Finally, we integrate the above-mentioned evidence with the current guidelines published by international societies, including AANS/CNS, EANO, AIOM, and NCCN.
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spelling doaj.art-2aee60f589a14e8e8107728ce17fde132023-12-01T23:27:56ZengMDPI AGBiomedicines2227-90592022-08-01108192710.3390/biomedicines10081927Recurrent Glioblastoma Treatment: State of the Art and Future Perspectives in the Precision Medicine EraAugusto Leone0Antonio Colamaria1Nicola Pio Fochi2Matteo Sacco3Matteo Landriscina4Giovanni Parbonetti5Matteo de Notaris6Giulia Coppola7Elena De Santis8Guido Giordano9Francesco Carbone10Department of Neurosurgery, Städtisches Klinikum Karlsruhe, 76133 Karlsruhe, GermanyDepartment of Neurosurgery, Riuniti Hospital, 71122 Foggia, ItalyDepartment of Neurosurgery, University of Foggia, 71122 Foggia, ItalyDepartment of Neurosurgery, Riuniti Hospital, 71122 Foggia, ItalyUnit of Medical Oncology and Biomolecular Therapy, Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, ItalyDepartment of Neurosurgery, “Rummo” Hospital, 82100 Benevento, ItalyDepartment of Neurosurgery, “Rummo” Hospital, 82100 Benevento, ItalyDepartment of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, 00185 Roma, ItalyDepartment of Anatomical Histological Forensic Medicine and Orthopedic Sciences, Sapienza University of Rome, 00185 Roma, ItalyUnit of Medical Oncology and Biomolecular Therapy, Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, ItalyDepartment of Neurosurgery, Städtisches Klinikum Karlsruhe, 76133 Karlsruhe, GermanyCurrent treatment guidelines for the management of recurrent glioblastoma (rGBM) are far from definitive, and the prognosis remains dismal. Despite recent advancements in the pharmacological and surgical fields, numerous doubts persist concerning the optimal strategy that clinicians should adopt for patients who fail the first lines of treatment and present signs of progressive disease. With most recurrences being located within the margins of the previously resected lesion, a comprehensive molecular and genetic profiling of rGBM revealed substantial differences compared with newly diagnosed disease. In the present comprehensive review, we sought to examine the current treatment guidelines and the new perspectives that polarize the field of neuro-oncology, strictly focusing on progressive disease. For this purpose, updated PRISMA guidelines were followed to search for pivotal studies and clinical trials published in the last five years. A total of 125 articles discussing locoregional management, radiotherapy, chemotherapy, and immunotherapy strategies were included in our analysis, and salient findings were critically summarized. In addition, an in-depth description of the molecular profile of rGBM and its distinctive characteristics is provided. Finally, we integrate the above-mentioned evidence with the current guidelines published by international societies, including AANS/CNS, EANO, AIOM, and NCCN.https://www.mdpi.com/2227-9059/10/8/1927recurrent glioblastomabrain tumorreviewglioblastoma treatmentchemotherapyregorafenib
spellingShingle Augusto Leone
Antonio Colamaria
Nicola Pio Fochi
Matteo Sacco
Matteo Landriscina
Giovanni Parbonetti
Matteo de Notaris
Giulia Coppola
Elena De Santis
Guido Giordano
Francesco Carbone
Recurrent Glioblastoma Treatment: State of the Art and Future Perspectives in the Precision Medicine Era
Biomedicines
recurrent glioblastoma
brain tumor
review
glioblastoma treatment
chemotherapy
regorafenib
title Recurrent Glioblastoma Treatment: State of the Art and Future Perspectives in the Precision Medicine Era
title_full Recurrent Glioblastoma Treatment: State of the Art and Future Perspectives in the Precision Medicine Era
title_fullStr Recurrent Glioblastoma Treatment: State of the Art and Future Perspectives in the Precision Medicine Era
title_full_unstemmed Recurrent Glioblastoma Treatment: State of the Art and Future Perspectives in the Precision Medicine Era
title_short Recurrent Glioblastoma Treatment: State of the Art and Future Perspectives in the Precision Medicine Era
title_sort recurrent glioblastoma treatment state of the art and future perspectives in the precision medicine era
topic recurrent glioblastoma
brain tumor
review
glioblastoma treatment
chemotherapy
regorafenib
url https://www.mdpi.com/2227-9059/10/8/1927
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