Glioblastoma Multiforme

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Contents

More Specific Terms

Epidemiology

Pathology

Microscopic-pathology

  • The presence of 3 of the above criteria (excluding #1) is sufficient for diagnosis of GBM; presence of necrosis is not necessary.

Genetics

  • Two subtypes based on clinical characteristics:
  • primary GBM associated with
  • secondary GBM associated with
  • initially
  • progressing with

Clinical-manifestations

  • case report [14]

Laboratory

  • biopsy (tissue needed for diagnosis)

Radiology

Management

  • 5000-6500 cGy
  • 60 Gy over a period of 6 weeks [10]
  • shorter course of 40 Gy in 15 fractions [10]
  • prolongs survival
  • administered in multiple fractions to an area around the tumor
  • radiation necrosis may produce clinical picture indistinguishable from recurrent high-grade tumor

Clinical-trials

More General Terms

Internet Database

OMIM: 137800

References

  1. OMIM 137800
  2. Mark Felmus, M.D., Ph.D., Dept. of Medicine, UCSF Fresno
  3. Medical Knowledge Self Assessment Program (MKSAP) 11, 16. American College of Physicians, Philadelphia 1998, 2012
  4. Levin et al, Neoplasms of the central nervous system, in: Cancer: Principles & Practice of Oncology, DeVita et al, eds, Lippincott, Williams & Wilkins, Philadelphia, 2001, pg 2100
  5. Stupp R, Hegi ME, Gilbert MR, Chakravarti A. Chemoradiotherapy in malignant glioma: standard of care and future directions. J Clin Oncol. 2007 Sep 10;25(26):4127-36. PMID: [1]
  6. Stupp R, Hegi ME, Mason WP et al Effects of radiotherapy with concomitant and adjuvant temozolomide versus radiotherapy alone on survival in glioblastoma in a randomised phase III study: 5-year analysis of the EORTC-NCIC trial. Lancet Oncol. 2009 May;10(5):459-66 PMID: [2]
  7. WHO Classification Tumours of the Nervous System. Kleihues & Cavenee eds. IARC Press 2000
  8. Stupp R et al Maintenance Therapy With Tumor-Treating Fields Plus Temozolomide vs Temozolomide Alone for GlioblastomaA Randomized Clinical Trial. JAMA. 2015;314(23):2535-2543 <PubMed> PMID: [3] <Internet> [4]
    - Sampson JH Alternating Electric Fields for the Treatment of Glioblastoma. JAMA. 2015;314(23):2511-2513 <PubMed> PMID: [5] <Internet> [6]
  9. Rusthoven CG et al. Combined-modality therapy with radiation and chemotherapy for elderly patients with glioblastoma in the temozolomide era: A National Cancer Database analysis. JAMA Neurol 2016 May 23 PMID: [7]
  10. Perry JR, Laperriere N, O'Callaghan CJ Short-Course Radiation plus Temozolomide in Elderly Patients with Glioblastoma. N Engl J Med 2017; 376:1027-1037. March 16, 2017 <PubMed> PMID: [8] <Internet> [9]
  11. Stupp R, Hegi ME, Idbaih A et al CT007 - Tumor treating fields added to standard chemotherapy in newly diagnosed glioblastoma (GBM): Final results of a randomized, multi-center, phase III trial. American Association for Cancer Research. 2017 Annual Meeting. Session CTMS01 - Breast Cancer, Ovarian Cancer, and Glioblastoma Clinical Trials. April 2, 2017 [10]
  12. Zhu Z, Gorman MJ, McKenzie LD Zika virus has oncolytic activity against glioblastoma stem cells. J Experimental Med. Sept 5, 2017 <PubMed> PMID: [11] <Internet> [12]
  13. Wick W, Gorlia T, Bendszus M et al Lomustine and Bevacizumab in Progressive Glioblastoma. N Engl J Med 2017; 377:1954-1963. November 16, 2017 <PubMed> PMID: [13] <Internet> [14]
  14. Siddiqui J, Krishnan AS. (images) Butterfly Glioma. N Engl J Med 2018; 378:281. January 18, 2018 <PubMed> PMID: [15] <Internet> [16]
  15. Fuerst ML Glioblastoma: 'Smart Bomb' Virus Induces Durable Responses. Adenovirus engineered to attack recurrent disease allowed 20% of patients to live at least 3 years, probably due to direct oncolytic effects. MedPage Today. ASCO Reading Room 04.12.2018 [17]
    - Lang FF, Conrad C, Gomez-Manzano C,et al Phase I study of DNX-2401 (Delta-24-RGD) oncolytic adenovirus: Replication and immunotherapeutic effects in recurrent malignant glioma. J Clin Oncol. 2018 Feb 12 PMID: [18]
  16. Castellino AM Dendritic Vaccine for Glioblastoma: Hope Hyped, Say Some. Medscape - Jun 13, 2018. [19]
    - Liau LM, Ashkan K, Tran DD et al First results on survival from a large Phase 3 clinical trial of an autologous dendritic cell vaccine in newly diagnosed glioblastoma. Journal of Translational Medicine. 2018. 16:142 PMID: Free PMC Article&dopt=Abstract [20]
  17. Desjardins A, Gromeier M, Herndon JE 2nd et al Recurrent Glioblastoma Treated with Recombinant Poliovirus. N Engl J Med. June 26, 2018 PMID: [21] [22]
    - Longo DL, Baden LR Exploiting Viruses to Treat Diseases. N Engl J Med. June 26, 2018 PMID: [23] [24]
  18. National Guideline Clearinghouse
    - The role of targeted therapies in the management of progressive glioblastoma: a systematic review and evidence-based clinical practice guideline. Congress of Neurological Surgeons ngc-guideline: [25]
    - Radiation therapy for glioblastoma: an ASTRO evidence-based clinical practice guideline. American Society for Radiation Oncology ngc-guideline: [26]

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