Management of newly diagnosed glioblastoma multiforme: current state of the art and emerging therapeutic approaches.
Level 5 - mechanism / opinion, no new human data
Narrative literature review synthesizing clinical trials and treatment strategies without systematic meta-analysis.
PubMed 35716200 · doi:10.1007/s12032-022-01708-w
What was done
The authors conducted a literature search of PubMed and Google Scholar through July 2021 using search terms including "glioblastoma," "glioblastoma multiforme," and "GBM." They reviewed current clinical data informing standard of care as well as ongoing clinical trials investigating novel therapeutics for newly diagnosed and recurrent disease.
What was found
The Stupp protocol (maximal safe resection followed by radiotherapy plus concurrent and adjuvant temozolomide) remains the established standard of care. Glioblastoma accounts for >50% of primary gliomas with an approximate 5% five-year survival rate. The addition of tumor-treating fields showed modest improvement in median overall survival and delayed time to cognitive decline across both MGMT-methylated and unmethylated tumors. Adding lomustine to temozolomide showed median overall survival benefit specifically in MGMT-methylated patients. Targeted therapy, anti-angiogenic therapy, and immunotherapy have not yet demonstrated survival advantages. Specific numerical effect sizes were not reported in the abstract.
Why it matters
This review highlights the persistent difficulty in translating promising preclinical targeted and immune-based therapies into clinical survival gains for glioblastoma, underscoring the limited shifts in frontline standard care since 2005.
Limits
The abstract describes a non-systematic narrative literature review without predefined inclusion criteria, formal risk-of-bias appraisal, or quantitative meta-analytic pooling. Specific survival metrics, hazard ratios, and sample sizes for the cited studies are omitted from the abstract.
Cited by
- contradicts There has been no advance in the management of glioblastoma in 100 years.